Injury prevention will be a central focus of trauma systems of the future
because it offers the greatest potential for reducing the burden - financial
and otherwise - of trauma care, as well as morbidity and mortality. At
the present time, t he public health infrastructure for injury prevention
varies greatly among states and regions. Funding for injury prevention
is often non-existent or limited, which prevents long-term implementation
and program evaluation.
Injury prevention is variably represented in trauma systems; the focus
has traditionally been on secondary and tertiary prevention (efforts
to reduce the impact of an injury once it has occurred and optimize its
outcome). Although primary injury prevention programs have been implemented
by pre-hospital and acute care providers, few have been systematically
evaluated.
Community-based injury prevention programs have been demonstrated to
avert injury-related morbidity and mortality and to reduce health care
costs, although there is a huge gap between what is known to be effective
and what is done at the local level. Prevention programs are often created
on demand (i.e., requested or based on a single incident) rather than
based on a systematic analysis of actual injury data. Prevention efforts
often are not targeted or evaluated in relation to community needs. In
many cases, injury prevention programs on similar topics are conducted
by various organizations in the same community without the benefit of
coordination.
• Each State will have a core injury prevention program that
provides assistance to local areas, with information and materials coordinated
via a central repository or clearinghouse. Specific injury prevention
programs will be based on a quantitative community health assessment.
The health assessments will be coordinated with other comprehensive public
health community assessments. All programs will be evaluated for their
effectiveness on a local level.
• Trauma registry data will help with problem identification
and program evaluation and will be fully coordinated with the EMS and
public health systems.
• A comprehensive study of the epidemiology of injuries and
trauma will be conducted and predictive models regarding injury occurrence
will be developed. The information gained through these efforts will
reduce the occurrence of injury, expedite the patient's return to productivity,
and minimize the impact of injury.
• Injury prevention legislation will be enacted, where compelling
evidence exists.
• Injury prevention efforts will be conducted on a collaborative
basis, with input from and the involvement of multiple stakeholders and
constituency groups. Trauma care systems will establish system-wide injury
control coalitions or coordinate with existing initiatives to provide
consistent and coordinated community-wide injury prevention programs.
I njury prevention programs developed by these coalitions will be evidence-based,
using local injury data where available (or linking existing data sources)
to identify prevention priorities within the community, with an emphasis
on decreasing risk factors. Program evaluation and outcome data will
be used to modify or create injury prevention programs, with special
effort given to developing rural and frontier models .
• Injury prevention will be recognized as a legitimate public
and governmental service, similar to other safety programs such as fire
prevention. Proper funding will be secured for injury prevention, with
a greater portion of public health dollars allocated for injury prevention.
• Injury prevention efforts will be seen as a legitimate
health care service that is directly reimbursable to providers.
• Injury prevention programs, and their availability to the
general public, will be required by lead agencies who designate all levels
of trauma centers and by the public health systems.
• Injury prevention will be integrated into existing health
delivery systems, such as pediatric and rural health clinics, and prevention
materials will be readily available at places where families usually
receive care. Age-appropriate injury prevention information will be added
to all periodic health examinations and risk assessment systems. Specialty
care providers will also identify injury management issues that specifically
relate to their practice area.