Background: Formalized trauma systems have shown beneficial effects on patient survival and have harvested\r\ngreat recognition among health care professionals. In spite of this, the implementation of trauma systems is\r\nchallenging and often met with resistance.\r\nRecommendations for a national trauma system in Norway were published in 2007. We wanted to assess the level\r\nof implementation of these recommendations.\r\nMethods: A survey of all acute care hospitals that receive severely injured patients in the south-eastern health\r\nregion of Norway was conducted. A structured questionnaire based on the 2007 national recommendations was\r\nused in a telephone interview of hospital trauma personnel between January 17 and 21, 2011. Seventeen trauma\r\nsystem criteria were identified from the recommendations.\r\nResults: Nineteen hospitals were included in the study and these received more than 2000 trauma patients\r\nannually via their trauma teams. Out of the 17 criteria that had been identified, the hospitals fulfilled a median of\r\n12 criteria. Neither the size of the hospitals nor the distance between the hospitals and the regional trauma centre\r\naffected the level of trauma resources available. The hospitals scored lowest on the criteria for transfer of patients\r\nto higher level of care and on the training requirements for members of the trauma teams.\r\nConclusion: Our study identifies a major shortcoming in the efforts of regionalizing trauma in our region. The\r\nfindings indicate that training of personnel and protocols for inter-hospital transfer are the major deficiencies from\r\nthe national trauma system recommendations. Resources for training of personnel partaking in trauma teams and\r\ndevelopment of inter-hospital transfer agreements should receive immediate attention.
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