Key messages

  • The State Trauma Committee contributes advice to the Minister for Health and the Department of Health & Human Services on matters relating to the Victorian State Trauma System.
  • The State Trauma Committee provides guidance and leadership in research and policy development.
  • The Trauma Case Review Group provides policy analysis and advice on cases that fall outside the Major Trauma Guidelines.

The Department of Health & Human Services and the Transport Accident Commission (TAC), under the guidance of the State Trauma Committee (STC), work collaboratively to ensure an efficient and effective trauma system and a smooth and systematic clinical pathway for the appropriate management of major trauma patients.

The STC provides guidance and leadership to the department and the Victorian State Trauma Registry (VSTR) regarding research and policy development. Research and policy initiatives support best evidence trauma management and provide clear and consistent trauma management guidelines.

State Trauma Committee terms of reference

The STC continues to oversee and build on over a decade of improvement in the VSTR. It is now considered a world leader in the management of the major trauma patient journey.

The committee provides advice on policy development, system performance and quality management strategies, to support:

  • clear and consistent system response to trauma management
  • definitive care for all patients at an appropriate health service
  • role delineation of health services, including the three major trauma services as centres of excellence
  • coordination and timely transfer of patients
  • education and training in the statewide system organisation and management of trauma response.

The committee advises on system performance monitoring initiatives, including thematic analysis of the Victorian State Trauma System (VSTS) using the VSTR to review system performance and inform system improvements.

The committee maintains a policy agenda to support the system improvements achieved over the past decade, and advises on specific matters referred to it for review and recommendations.

The committee develops and maintains relationships with, and provides advice and support to, other trauma-related committees, for example, the Road Safety Committee.

Membership and meeting arrangements

STC membership comprises representatives from tertiary, metropolitan, regional and rural trauma services:

  • Chairperson
  • Director of Trauma Services, The Royal Children’s Hospital
  • Director of Trauma Services, The Royal Melbourne Hospital
  • Director of Trauma Services, Alfred Health
  • General Manager, Ambulance Victoria
  • Director, Adult Retrieval Victoria
  • Director, Victorian Spinal Cord Service, Austin Health
  • Senior Representative, Metropolitan Trauma Service
  • Representative, Australasian College of Emergency Medicine
  • Senior Representative, Regional Trauma Service
  • Trauma Nurse, College of Emergency Nursing Australasia
  • Chair, Victorian Trauma Committee, Royal Australasian College of Surgeons
  • Representative, Transport Accident Commission
  • Executive Representative, Epworth Rehabilitation
  • Manager, Ambulance and Emergency Programs, Department of Health & Human Services.

Membership requirements

Membership is in accordance with government policies and procedures.

Organisations nominate candidates who are considered experts in their field and who have the support of their employer to attend meetings (where applicable).

Members are required to attend at least 75 per cent of meetings and make a significant contribution to the committee.

Proxies on behalf of an absent member are not permitted.

Committee chairperson

The committee chairperson is appointed for a three-year term by the Minister in accordance with government policies and procedures.

The committee chairperson must not be an employee of a major trauma service, and should have experience in, and understanding of the VSTS.

Quorum

A quorum at committee meetings is defined as the physical presence of half the members then in office. In the event of the quorum not being achieved, a decision on whether to continue the meeting occurs at the time.

Frequency of meetings

Committee meetings are held three times per year.

Term of the STC

The department may review the terms of reference annually in accordance with government policies and procedures, and with ministerial endorsement.

Membership may be reviewed in conjunction with review of the terms of reference, to ensure representation appropriately reflects the objectives and priorities of the committee.

The chair and members are appointed for a period of three years. The chair and members may be re-appointed for subsequent terms.

Linkages

The committee consults with clinical colleges, professional clinical organisations, trauma committees and other key stakeholders to ensure appropriate additional input from relevant professions, as required.

Reporting arrangements

The chair of the committee is responsible to the Minister for Health and the Department of Health & Human Services and communicates through the Ambulance and Emergency Program.

Secretariat

The department's Emergency and Trauma Program provides secretariat services.

Trauma Case Review Group terms of reference

The Trauma Case Review Group (CRG) is a subcommittee of the STC. The CRG provides policy analysis and best practice advice to the Department of Health & Human Services, advisory groups and health services on major trauma cases that fall outside the Major Trauma Guidelines.

The CRG terms of reference are:

1. to advise the the department and the State Trauma Committee (STC) on policy development related to major trauma patient transfers about:

  • immediate pre-hospital system response
  • coordinated trauma system response
  • patient retrieval.

2. to perform system-wide analysis of major trauma patient transfer and outcomes:

  • evaluating core components of the transfer system
  • providing feedback to the department and STC regarding:
  • transfer
  • specific outliers
  • sentinel events affecting transfer
  • non-transfer to Major Trauma Services of major trauma patients
  • prolonged transfer timeframes.

3. to provide best practice advice in the transfer of major trauma patients in the pre-hospital and hospital settings, in relation to:

  • trauma registry indicators
  • transfer logistic
  • clinical risk.

4. To improve the quality and safety of major trauma care by providing feedback to health services and ambulance services on defined major trauma cases that fall outside the Major Trauma Guidelines.

5. to provide advice and recommendations to the department and STC on system issues identified by the case review process.

Membership of the CRG

Membership includes the following representatives of the VSTS:

  • Regional Services, Ambulance Victoria (Chairperson)
  • Director, Adult Retrieval Victoria
  • Head, Victorian State Trauma Registry
  • Data Manager, VSTORM
  • Manager, Emergency and Trauma Program, Department of Health
  • Emergency clinician, Major Trauma Service
  • Emergency clinician, Metropolitan Trauma Service
  • Emergency clinician, Regional Trauma Service
  • Trauma Coordinator (paediatrics), Major Trauma Service
  • Representative, Neurosurgery
  • Representative, Department of Health Regional Office
  • Representative, Director of Medical Services
  • Representative, Transport Accident Commission.

Communication arrangements

The chair of the committee provides recommendations to the department and STC and advisory groups as required.

Frequency of meetings

Meetings are held three times a year. Members are required to attend the majority of meetings annually.

Review

The department may review the terms of reference annually. Membership may be reviewed in conjunction with the review of the Terms of Reference.

The chair and members are appointed for a period of three years. The chair and members may be re-appointed for a subsequent term.

Committee support

The department's Emergency and Trauma Program provides secretariat support to the committee.

Trauma case review filters

The CRG meets to review data from the VSTR, which comprises de-identified major trauma cases that meet certain parameters or ‘filters’ for review. Major trauma cases that meet a parameter for review by the CRG are referred to as outlier cases.

1. All major trauma transfers to a service with a lower designation or transfer to a non-major trauma service (excluding spinal patients transferred to the Austin and elderly (≥65) low falls with isolated head injury to The Austin, Monash Medical Centre and St Vincent’s Hospital):

  • SBP<100mmhg>
  • 02 saturation <97%>
  • Pulse rate <60bpm or="">120bpm at scene
  • GCS motor=1
  • GCS verbal <5>

2. All major trauma patients who receive definitive care at a non-major trauma service (excluding spinal patients transferred to the Austin and elderly (≥65 low falls with isolated head injury to The Austin, Monash Medical Centre and St Vincent’s Hospital):

  • SBP<100mmhg>
  • 02 saturation <97%>
  • Pulse rate <60bpm or="">120bpm at scene
  • GCS motor=1
  • GCS verbal <5>

3. Time critical major trauma transfer time >6 hours from time of arrival at first hospital to time of arrival at definitive hospital.