title: Implementation of recommended trauma system criteria in south-eastern Norway: a cross-sectional hospital survey.
abstract: BACKGROUND
  Formalized trauma systems have shown beneficial effects on patient survival and have harvested great recognition among health care professionals. In spite of this, the implementation of trauma systems is challenging and often met with resistance.Recommendations for a national trauma system in Norway were published in 2007. We wanted to assess the level of implementation of these recommendations.
  
  
  METHODS
  A survey of all acute care hospitals that receive severely injured patients in the south-eastern health region of Norway was conducted. A structured questionnaire based on the 2007 national recommendations was used in a telephone interview of hospital trauma personnel between January 17 and 21, 2011. Seventeen trauma system criteria were identified from the recommendations.
  
  
  RESULTS
  Nineteen hospitals were included in the study and these received more than 2000 trauma patients annually via their trauma teams. Out of the 17 criteria that had been identified, the hospitals fulfilled a median of 12 criteria. Neither the size of the hospitals nor the distance between the hospitals and the regional trauma centre affected the level of trauma resources available. The hospitals scored lowest on the criteria for transfer of patients to higher level of care and on the training requirements for members of the trauma teams.
  
  
  CONCLUSIONS
  Our study identifies a major shortcoming in the efforts of regionalizing trauma in our region. The findings indicate that training of personnel and protocols for inter-hospital transfer are the major deficiencies from the national trauma system recommendations. Resources for training of personnel partaking in trauma teams and development of inter-hospital transfer agreements should receive immediate attention.
authors.affiliation: Department of Research, Norwegian Air Ambulance Foundation, Drøbak, Norway. thomas.kristiansen@norskluftambulanse.no
authors.forename: Thomas
authors.initials: T
authors.lastname: Kristiansen
authors.forename: Kjetil G
authors.initials: KG
authors.lastname: Ringdal
authors.forename: Tarjei
authors.initials: T
authors.lastname: Skotheimsvik
authors.forename: Halvor K
authors.initials: HK
authors.lastname: Salthammer
authors.forename: Christine
authors.initials: C
authors.lastname: Gaarder
authors.forename: Pål A
authors.initials: PA
authors.lastname: Naess
authors.forename: Hans M
authors.initials: HM
authors.lastname: Lossius
mesh_terms: D002391:Catchment Area, Health; D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D057209:Hospital Rapid Response Team / Q000458:organization & administration; D006801:Humans; D009664:Norway; D010360:Patient Transfer; D016730:Program Development; D019035:Rural Health Services / Q000458:organization & administration; D011795:Surveys and Questionnaires; D014193:Trauma Centers / Q000458:organization & administration* / Q000592:standards; D014194:Traumatology / Q000458:organization & administration* / Q000592:standards; D014947:Wounds and Injuries / Q000628:therapy*