Violence and Injury Prevention

Trauma system maturity index

Trauma system maturity index is a quick self-assessment tool to determine the maturity of trauma system in a given geopolitical area e.g. a district, province or a country. It also demonstrates what actions are needed by the managers and planners to develop the system and allows broad comparison of trauma systems. The systems are graded from Level I (least mature) to Level IV (most mature). It also indicates the roadmap to progress to the next level up on the maturity scale.

Unless all features in the Level are met, previous level of maturity in the index applies.

  Level I Level II Level III Level IV
Prehospital Trauma Care No mapping of prehospital resources, No formal EMS, unavailability or duplication of prehospital services, no defined communication system Prehospital Resources are identifiable, no coordination between public and private providers of prehospital care, No universal access number, weak links of communication Formal EMS present, Universal Access Number available, Coordination seen between various agencies for prehospital care delivery, well defined communication Formal EMS controlled by a lead agency, National universal access number, Legislative mechanism in place to govern EMS and allow universal coverage
Education and Training No identified health personnel to offer primary trauma care in community Identified health personnel in the community for emergency trauma care, no definite training requirement for health workers or ambulance personnel Health professionals and Paramedics are trained in provision of emergency trauma care, training courses are available for trauma education Educational standards and training for emergency trauma care providers laid down, Licensing and renewal norms for different levels of paramedics are in place
Facility based Trauma care Role of secondary and tertiary facilities unclear, Health facilities lack human and physical resources, no clear referral linkages Roles of various Health care facilities are clear, Referral linkages are present, No documentation or needs assessment of facilities as per EsTC , no lead agency in the system Health facilities in the systems are assessed as per EsTC guidelines and documented human and physical resources are available and ensured round the clock, lead agency present Mechanism of Hospital verification and accreditation is in place through MOH or professional bodies, lead agency established with mandate to supervise trauma care
Quality Assurance No injury surveillance or registry mechanism in place to get comprehensive data Injury data available but no formal attempts to document and analyze the data, no initiative for Q/A programme Basic Quality Assurance programmes as per EsTC guidelines are in place Formal Quality Assurance programmes are in place and are mendated in prehospital and facility based services