1. Vanore, Marla L. RN, MHA President, Society of Trauma Nurses

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Much has been happening in trauma on a national level in the United States recently, some good and some not so good. It seems as though we continue to take 2 steps forward and 1 step back, but at least we are moving forward.



First, let me tell you the good news. On February 23, 2006, the Model Trauma Systems Plan was officially unveiled. This has been a long time coming. This document was originally released as a draft by the US Department of Health and Human Services in the Health Resources and Services Administration (HRSA) in 1992. It was meant to be a reference guide that could be used by individual states to design their trauma system. Although it was used in its draft form, it was never finalized-until now. Most recently, a number of organizations, including the Society of Trauma Nurses (STN), were involved in reviewing, revising, and rewriting this plan. This is a valuable resource for all trauma systems, whether they are just beginning to develop or are already a mature system. See Mike Glenn's Editorial "What Are We and Where Are We Going?" in this issue for more information on this important document, which can affect all of us in trauma care. Mike Glenn is the Assistant Administrator, Division of EMS, and Ohio State Trauma System Manager and is also on the STN Board of Directors, in the position of Secretary.



Also unveiled in February was the National Trauma Registry Standardization Project Data Dictionary. This is an exciting undertaking to standardize a core set of data elements that all states will be asked to collect and report. This project is attempting to fill a void that has long been recognized. Despite the presence of trauma systems for over 30 years and of numerous state trauma registries, there has been no standard set of variables that could be aggregated nationally. Currently, some states operate very developed trauma registries, whereas some have none. States differ in the types of patients that are included, and the definitions of data points differ from state to state. This new minimal data set, which will be housed by the American College of Surgeons (ACS) National Trauma Data Base, is the first step in the development of a national trauma registry. Having this type of national database will be extremely beneficial to the study of trauma systems and trauma clinical care as well as to efforts to obtain federal funding for trauma.


The data set was developed with the input of many experts in the field, including a number of STN members, and it includes pediatric data points developed by pediatric trauma experts. Also, the plan includes the ability to link with the National EMS Information System, which contains data from local and state EMS agencies from across the nation. Trauma will be able to obtain data from the EMS system and the EMS system will be able to gather some outcomes data from the trauma registry. I am sure that you will agree that, over time, the development of this national trauma registry will greatly benefit the trauma and EMS communities and trauma care in general. The data set and web casts that describe the development process and important next steps can be viewed at I also encourage all states to review and sign onto the posted MOU on this Web site so that the long-range goal of having a national trauma registry will be realized.



Unfortunately, as I mentioned earlier, not all of the news have been positive. Federal funding that had been available for the development of trauma systems since 1990 was cut from the budget for fiscal year 2006. This money created the Trauma-Emergency Medical Services System in HRSA. Under Cheryl Anderson's leadership, this program helped to make huge strides in the development of trauma systems across the United States. Through small grants, some states were able to make great progress in developing their state trauma systems and states with mature systems were able to acquire grants to make improvements. In addition, grant holders were required to attend an annual meeting where, for the first time ever, state trauma system managers could network, share information, and work together. This program greatly benefited many states and the nation as a whole.


Many other Trauma initiatives have benefited from HRSA funding including the development of the National Trauma Registry Standardization Project Data Dictionary previously discussed. TOPIC, STN's trauma outcomes and performance improvement course, also greatly benefited from funding received through a HRSA Trauma grant. Through the grant, we were able to increase the number of courses presented, improving the knowledge of trauma performance improvement for many trauma practitioners.


Loss of this funding has caused the dissolution of the entire HRSA trauma program. As I write this editorial today, work is under way to attempt to reinstate funding for fiscal year 2007. As leaders in trauma care, I call upon you to visit the STN ( and ACS ( Web sites frequently and to stay alert to listserv notices for calls to action for trauma funding. You can also register at to receive e-mails from the ACS Legislative Action Center and for notices of important times to act. I also encourage you to use the ACS site to e-mail letters to your legislators. This is quick and easy to do and provides information to ACS when they state their case to the appropriate legislators. Remember, when you communicate with your legislators, always let them know that you are a trauma nurse and a voter. This combination is extremely powerful.


I hope that by the time that you read this journal issue, we would have been successful in reinstating this funding. However, this situation proves that we can never take trauma funding for granted. It is always at risk. It may be exceedingly clear to us why trauma systems and trauma centers are even more important now with the threat of terrorist and natural disasters, but this is not always clear to those who have the power to allocate this money.


In summary, our efforts to create a nationwide trauma system in the United States and, I am sure, in many other countries continue to be a challenge. For every major step forward, we need to be vigilant to ensure that efforts that we may have taken for granted are not lost.



I would also like to welcome 2 important additions to the STN leadership team.


I am very happy to announce Kathryn Schroeter, PhD, RN, CNOR, as the new editor in chief of the Journal of Trauma Nursing. Kathryn has a wealth of experience in editing, writing for publication, education, and clinical care. We are extremely fortunate to have her join us.


Pat Manion, RN, MS, CCRN, CEN, Trauma Coordinator at Genesys Regional Medical Center in Michigan, has also joined us as Annual Conference Chair. Pat has been a member of the planning committee for the past 2 years and has led many successful conferences in her home state.


I am sure that you will be hearing a lot from both Kathryn and Pat in the near future.