Zero preventable deaths after traumatic injury: An achievable goal.

Preventable deaths after injury must be reduced to improve outcomes for trauma patients. The elimination of preventable deaths after injury has been documented by the 75th US Army Ranger Regiment. Therefore, zero preventable deaths after injury is an achievable goal. Trauma is the most common cause of death between the ages of 1-46 and is the most common cause of life-years lost, before 75 years of age, compared to all other etiologies. Traumatic Hemorrhagic Shock (THS) is the leading cause of death that is preventable after injury, accounting for potentially 17,000 preventable deaths per year in the US. Civilian and US Military data estimate that upwards of 20-27.5% of trauma related deaths are preventable, respectively, and that 64-90% of these preventable deaths are due to THS. To achieve the goal of zero preventable deaths after injury a systematic approach is needed that can be modeled as a learning health care system (LHCS). Successful LHCS's are characterized by; leadership with authority and accountability that fosters a culture of learning; a highly coordinated performance improvement process that captures all aspects of patient care; that is transparent, and allows for rapid real time assessment of performance; a system for ensuring the maintenance of an expert trauma care workforce; and patient-centered care. In addition, the use of implementation science principles, and cost-effectiveness analyses are tools that can be used effectively to improve trauma systems. Lack of funding for trauma research is a major barrier for improving outcomes after traumatic injury. Trauma research is and has remained the lowest funded illness for the burden of disease it creates in our society when compared to all other diseases. Increased resources and an integrated military and civilian trauma system are required to achieve zero preventable deaths after injury in the United States. (C) 2017 Lippincott Williams & Wilkins, Inc.

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