Welcome
The Trauma Audit & Research Network (TARN)
Data Collection session
Today
 Background
 Inclusion criteria
 Identifying cases
 Quality Assurance: Data Accreditation and Completeness
 Data Entry
 Injury scoring & calculating the ISS (Injury Severity Score)
 Ps14 (Probability of Survival) & Hospital Survival rate (Ws)
TARN
 Largest European Trauma registry
Over 500,0000 injured patients with more than 46,000
injured children
 Review and monitor processes of care & outcomes
 Report to trusts & commissioners
 Inform changes in practice: Improve Trauma Care
TARN Team
Administrator/PA:
Gemma Reed
Projects Manager:
Victoria Phillipson
Coding team:
Laura Blakeley
Naomi Brook
Paul Gembarski
Phil Hammond (Supervisor)
Corinne Tilley
Victoria Zagrodnik
Registry Manager:
Tom Jenks
Training & Audit Manager:
Laura White
Systems Analysts:
Marisol Fragoso
Sophie Jones
Tom Lawrence
Mike Young
Medical Statistician:
Omar Bouamra
Financial Accountant:
Jean Hodkinson
Executive Director:
Maralyn Woodford
Operations Director & Deputy to
the Executive Director:
Antoinette Edwards
TARN
 Academic: University’s of Manchester, Sheffield and Leicester
 Non Profit making
 100% membership in England and Wales
 Members in Southern Ireland, Denmark and Switzerland
 Clinically led
 BOARD and Executive Committees
 Research and Audit Committees
TARN Research Committee
Director: Professor Fiona Lecky, Clinical Professor & Honorary Consultant in Emergency
Medicine (EM) at ScHARR and Salford Royal NHS Foundation Trust
11 members including: Executive Director, Medical Statistician, Registry Manager, Data
Analysts, Clinical Research Advisor, Research Fellows, Pre-hospital research advisor.
Meet Monthly to review:
 Ongoing Research projects
 New Research proposals
 Meetings & teleconferences with researchers
Have you got a Research
idea?
Complete Request form or
email Support@tarn.ac.uk
TARN Audit Committee
Director: Dr Dhushy Kumar, Consultant in Critical Care, Pre-hospital Care and
Anaesthesia at University Hospital Coventry.
15 members - National representation: Clinicians, TNCs, Data Coordinators,
Rehabilitation, TARN Executive Director, TARN Registry & Training Managers
Meet 6 times per year to discuss audit changes
Have you got an audit
request?
Email
Support@tarn.ac.uk
The beginning
 1988: Report by RCS: The Management of patients with Major Injuries
“Serious deficiencies in the management of severely injured patients”
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Enhancing pre-hospital care, ensuring appropriate medical intervention
Rapid transfer to the best local facility
Assessing the use of helicopters
Adopting ATLS principles
Integrating trauma services within and between hospitals
Investing in rehabilitation services
 System of Auditing & Research
 TARN Established in 1989: Based Salford Royal Hospital
Major Trauma reports
 2000: Joint report by RCS and BOA: Better Care for the Severely Injured
“Standards & outcome measures developed, against which institutions can audit the
outcome of treatment”
 2007: NECPOD: Trauma: Who cares?
“Given the importance of evaluation of processes and outcomes in the trauma patient,
all units providing treatment for severely injured patients should contribute to the
Trauma Audit & Research Network”
Major Trauma Network development
Public Accounts Committees March 2010
Chief Executive of NHS on public record as ......
 Committing to development of Major Trauma Networks across England by end
of 2011/12

Mandating TARN membership
 Most Major Trauma Networks “live” April 2012
17 Major Trauma Network and Major Trauma Centres (MTCs)
Greater Manchester Network
Salford Royal Hospital
Wythenshawe Hospital
Manchester Royal Infirmary
Royal Manchester Children’s Hospital
Merseyside & Cheshire Network
University Hospital of Aintree
Walton Centre for Neurology
Royal Liverpool University Hospital
Alder Hey Children’s Hospital
South Cumbria & Lancashire Network
Northern
James Cook University Hospital
Royal Victoria Infirmary, Newcastle
North
East
Yorkshire & Humber
S. Cumbria &
Lancashire
Leeds General Hospital
Sheffield Teaching Hospital NHS Trust
Sheffield Children’s Hospital
Hull Royal Infirmary
Yorkshire &
the Humber
Greater
Manchester
East Midlands Network
Royal Preston Hospital
Nottingham University Hospital
Merseyside &
Cheshire
N.W.
Midlands
West Midlands Network
East of England Network
Addenbrooke’s Hospital
Centre of
England
North West Midlands Network
Royal Stoke University Hospital
Centre of England Network
University Hospital of Coventry & Warwickshire
East
Midlands
East of
England
Birmingham &
Black Country
Thames
Valley
Birmingham and the Black Country Network
Queen Elizabeth Hospital, Birmingham
Birmingham Children’s Hospital
Royal London Hospital
NW London Network
St. Mary’s Hospital
London
Severn
SE London Network
Kings College Hospital
Sussex
Peninsula
NE London Network
Wessex
SW London Network
Severn Network
Southmead Hospital
Bristol Royal Children’s Hospital
St. George’s Hospital
Thames Valley Network
John Radcliffe Hospital
Sussex Network
Royal Sussex County Hospital
Peninsula Network
Derriford Hospital
Wessex Network
Southampton General Hospital
What has changed
On scene patient triage: Positive
Direct to MTC
(< 45 mins travel)
TARN
MAJOR TRAUMA CENTRE
Consultant led trauma team
Immediate operating theatre
All specialties: neurosciences
Immediate CT scan
Interventional radiology
Specialist critical care
Indirect Transfer
(>45 mins, time critical intervention)
Trauma Unit
Trauma team
Immediate CT Resuscitate,
Assess & ? Transfer
Major Trauma Centre: Best Practice Tariff Year 3 (14-15)

Additional payment made to Major Trauma Centres only

Based on Injury Severity

Moderate Trauma (ISS>8): £1,500

Major Trauma (ISS>15): £3,000

Payment conditional on Best Practice criteria being met
Major Trauma Centre: Best Practice Tariff Year 3 (14-15)
Level 1 (Moderate Trauma): Injury Severity Score >8
 TARN data is completed and dispatched within 25 days of discharge/death.
 Rehabilitation prescription completed for each patient & recorded on TARN.
 Tranexamic acid (TXA) administered within 3 hours of injury for any patient
receiving blood: Exclusions: Isolated Serious (Severity 3+) Head injuries
 Non-emergency transfers: Patient must be admitted to MTC within 2 calendar
days of referral from Trauma Unit
Major Trauma Centre: Best Practice Tariff Year 3 (14-15)
Level 2: (Major Trauma) Injury Severity Score >15
Level 1 criteria and following additional criteria met:
 Direct admissions or emergency (<12 hour) transfers: Patient must be seen
by Consultant within 5 minutes of arrival
 Direct admissions: Head CT performed within 1 hour of arrival for patients
with SeeAIS1+ Head injury & GCS <13 in ED (or intubated pre-hospital)
 Exclusions: patients requiring emergency surgery or interventional radiology within 1 hour of admission
Additional BPT fields added to TARN database
Web-based Trauma Data Collection
 Electronic data collection & reporting system
 Secure on-line system through patient pathway
 Data Collection AND Reporting
TARN Reports

Clinical Reports: Published March, July, November. Email notification to all users

Performance Comparisons: Updated March, July, November. Available to all.

Online Reports: Self produced reports

Ad Hoc analysis: Available any time
Separate
Reporting
Training session
Questions?