QEII Inpatient Trauma Consult Service
A recent evaluation of trauma care provided at the QEII by the NS Health Trauma Program of Care shows evidence of increased patient mortality after admission, increasing length of stay, and increased cost of patient care compared to other Level 1 trauma centers in Canada. These findings indicate that trauma care at the QEII is underperforming and requires improvement.
Prior to October 17, 2022, physicians who participate in the current trauma service, referred to as Trauma Team Leaders (TTLs), only provided care during the initial encounter in the emergency department. The care of patients, once admitted was under the care of various physicians with varying knowledge of trauma care, depending on their primary diagnosis and reason for admission. On October 17 2022, a dedicated trauma consult service was implemented at the QEII, staffed with appropriately skilled and motivated physicians and nurses to facilitate the care of trauma patients on a daily basis (365 days/year). This will result in a dramatic and sustained improvement in outcomes by allowing for the provision of comprehensive trauma care by dedicated attending physicians, which is required for Canadian Level 1 trauma centres by Accreditation Canada.
Creation of this service will help fill a major gap in trauma care at the QEII, which was previously identified in an external review of the trauma system in Nova Scotia. In the new model, a Trauma Consult Physician (Attending Physician) and a Trauma Consult Nurse (Registered Nurse) provide longitudinal care of all trauma inpatients after trauma team resuscitation for the entire inpatient admission. The new Consult Team also provides education and cohesiveness within the team of practitioners that care for trauma inpatients on multiple patient care units.
Following the launch of the QEII Inpatient Trauma Consult Service on October 17 2022, we will longitudinally evaluate patient outcomes and key performance indicators to measure our progress and identify any ongoing deficiencies that need to be addressed. Data will be routinely collected by the NS Health Trauma Program of Care and stored in the provincial trauma registry to enable robust analysis. This data will inform the creation of a dedicated trauma unit and service in future work.
The flowchart below outlines some of the changes in trauma care that will occur with the addition of the new Trauma Consult Service at the QEII: