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Published at www.cmaj.ca on Mar. 11
Major urban hospitals in New Brunswick will be precluded from denying trauma treatment to patients being transferred from rural and remote areas under a new provincial trauma system.
"It is essential that a 'no refusal' policy be implemented for all receiving centres in order to ensure that patients are transferred from sending to receiving hospitals with the maximum efficiency, in order to reduce potential morbidity," concluded the final report of a committee struck to develop a blueprint for provincial trauma services. Efforts to reform New Brunswick trauma care were launched in the wake of a highly publicized incident in which a rural resident waited 18 hours before entering the province's main trauma centre following an automobile accident (see sidebar).
Containing 112 recommendations, the New Brunswick Trauma System Final Report is the product of almost 20 months of work by some 100 health care workers (www.gnb.ca/0051 /pdf /6832-e.pdf). Its goal: to create a coordinated trauma network that can treat patients injured anywhere in the province without unnecessary delay - particularly when it comes to New Brunswick's annual load of roughly 250 major traumas.
The no-refusal policy is viewed as key to ensuring that patients do not become victims of bureaucratic wrangling between hospitals.
To achieve that, the report prescribes that "all Level 1, 2 and 3 facilities must have a Trauma Team Leader (TTL) on call 24 hours per day and the Trauma Control Physician (TCP) or TTL readily available at all times. For Level 1 facilities, the TCP should also be the TTL. The TCP should not have any other...