title: Implementing Major Trauma Audit in Ireland.
abstract: BACKGROUND
  There are 27 receiving trauma hospitals in the Republic of Ireland. There has not been an audit system in place to monitor and measure processes and outcomes of care. The National Office of Clinical Audit (NOCA) is now working to implement Major Trauma Audit (MTA) in Ireland using the well-established National Health Service (NHS) UK Trauma Audit and Research Network (TARN).
  
  
  OBJECTIVE
  The aim of this report is to highlight the implementation process of MTA in Ireland to raise awareness of MTA nationally and share lessons that may be of value to other health systems undertaking the development of MTA.
  
  
  METHODS
  The National Trauma Audit Committee of the Royal College of Surgeons in Ireland, consisting of champions and stakeholders in trauma care, in 2010 advised on the adaptation of TARN for Ireland. In 2012, the Emergency Medicine Program endorsed TARN and in setting up the National Emergency Medicine Audit chose MTA as the first audit project. A major trauma governance group was established representing stakeholders in trauma care, a national project co-ordinator was recruited and a clinical lead nominated. Using Survey Monkey, the chief executives of all trauma receiving hospitals were asked to identify their hospital's trauma governance committee, trauma clinical lead and their local trauma data co-ordinator. Hospital Inpatient Enquiry systems were used to identify to hospitals an estimate of their anticipated trauma audit workload.
  
  
  RESULTS
  There are 25 of 27 hospitals now collecting data using the TARN trauma audit platform. These hospitals have provided MTA Clinical Leads, allocated data co-ordinators and incorporated MTA reports formally into their clinical governance, quality and safety committee meetings. There has been broad acceptance of the NOCA escalation policy by hospitals in appreciation of the necessity for unexpected audit findings to stimulate action.
  
  
  CONCLUSIONS
  Major trauma audit measures trauma patient care processes and outcomes of care to drive quality improvement at hospital and national level. MTA will facilitate the strategic development of trauma care in Ireland by monitoring processes and outcomes and the effects of changes in trauma service provision.
authors: Clinical Lead, Major Trauma Audit, National Office of Clinical Audit, Emergency Medicine, Cork University Hospital, Wilton, Cork, Ireland. Electronic address: conor.deasy@hse.ie.
authors: Conor
authors: C
authors: Deasy
authors: National Office of Clinical Audit, 121 St Stephens Green, Dublin 2, Ireland.
authors: Marina
authors: M
authors: Cronin
authors: National Office of Clinical Audit, 121 St Stephens Green, Dublin 2, Ireland.
authors: Fiona
authors: F
authors: Cahill
authors: Consultant in Emergency Medicine, St. James's Hospital, Dublin 8, Ireland.
authors: Una
authors: U
authors: Geary
authors: Emergency Medicine, Beaumont Hospital, Dublin 9, Ireland.
authors: Patricia
authors: P
authors: Houlihan
authors: Trauma Audit and Research Network, UK.
authors: Maralyn
authors: M
authors: Woodford
authors: Trauma Audit and Research Network, UK.
authors: Fiona
authors: F
authors: Lecky
authors: National Office of Clinical Audit, 121 St Stephens Green, Dublin 2, Ireland.
authors: Ken
authors: K
authors: Mealy
authors: Quality Improvement Division, Health Service Executive, Dublin 8, Ireland.
authors: Philip
authors: P
authors: Crowley
mesh_terms: D019983:Guideline Adherence; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008485:Medical Audit; D009104:Multiple Trauma / Q000453:epidemiology*; D061214:Patient Safety; D017410:Practice Guidelines as Topic; D016730:Program Development; D058996:Quality Improvement / Q000458:organization & administration*; D019984:Quality Indicators, Health Care; D014193:Trauma Centers / Q000458:organization & administration / Q000592:standards
keywords: Audit; Injury; Ireland; Major trauma; Patient Safety; Quality; Register; Registry; Trauma