Grant: Project Grant

Preventable injuries are the leading cause of life years lost, and cost more than heart disease and stroke combined. To reduce the burden of injury, most Canadian health authorities have developed regionalized trauma systems comprising a series of lead trauma centers with surrounding referring centers. The role of the latter is to rapidly evaluate and stabilize people with severe injury before transferring them to a lead trauma center. Referring centers can also admit patients with minor to moderate injury, allowing them to stay closer to home. Despite evidence that patients with minor to moderate injury do not have better outcomes when they are treated in a lead trauma center, 11-49% of these patients are still transferred to a lead trauma center, distancing patients from their families and communities and generating significant expenses for their visiting caregivers. We aim to identify strategies to reduce avoidable inter-hospital transfers following injury in Canada. To do so, we will first assess current transfer practises. Second, we will interview patients and caregivers to understand their experiences and preferences then interview clinicians to understand how we can facilitate the management of patients with minor to moderate injuries in referring centers. Third, we will measure the resources that could be saved by the health system and by patients and caregivers if avoidable transfers were reduced. Fourth, we will use this information to identify strategies to reduce avoidable transfers. These may include decision support systems or clear guidance on which patients may be safely managed in referring centers. This project has the potential to improve patients' and caregivers' experience by reducing distress and personal costs and increasing social support during hospitalisation following injury. It could also reduce pressure on pre-hospital transport systems and free up resources in lead trauma centers.