The manner in which accident victims receive initial care and are treated has developed to a large extent over the last thirty years. The experience yielded by modern armed conflicts, new testing technologies and recent scientific studies has led to a better understanding of the causes of death due to trauma and ways to reduce subsequent mortality and morbidity. All modern societies have acknowledged that the best way to improve the survival of accident victims is to reduce waiting times for access to necessary services and care.
In 1984, the Société de l’assurance automobile du Québec (SAAQ) financed a study, the results of which advocated use of an integrated approach to care for victims of head trauma. In 1987, with the approval of the Ministère de la Santé et des Services sociaux (MSSS), the SAAQ signed agreements with a number of rehabilitation care facilities, resulting in the emergence of highly specialized care in some of these rehabilitation facilities. In 1991, these agreements were extended to early rehabilitation services that were available in some hospital centres specialized in neurotrauma. They were broadened again in 1997 to include spinal cord injury victims, and once again in 2000 to include services to victims of severe orthopedic injuries.
In the early 1990’s, the Ministère de la Santé et des Services sociaux (MSSS) mandated the Société de l’assurance automobile du Québec (SAAQ) to organize the province’s trauma care and services network.
In June 2010, the Act respecting the Institut national d’excellence en santé et en services sociaux (INESSS) was assented to by the National Assembly of Québec. The Act resulted in the merger between the Conseil du médicament and the Agence d’évaluation des technologies et des modes d’intervention en santé (AETMIS). As a result, AETMIS’s Trauma Services Continuum Assessment Team is now managed by INESSS.
A follow-up study on the effects of implementing the TSC revealed lower mortality rates among victims with serious injuries, which fell from 51.8% in 1992 to 8.6% in 2002. These data come from the trauma Registry, which was created in partnership with the MSSS, SAAQ and McGill University, as a means of monitoring the progress of the TSC.
This unique Trauma Services Continuum model emerged as the result of a partnership with the health and social services network. It is the product of several years of hard work on the part of all partners of the network to ensure that waiting times for access to quality care are as short as possible, regardless of Québec geography and demographics.
In a 2004–2005 report, the Auditor General of Québec (AGQ) concluded that the Trauma Services Continuum for people with a moderate-to-acute TBI satisfied most of the AGQ’s assessment criteria for physical health and specialized rehabilitation services provided in the Capitale-Nationale and Bas-Saint-Laurent regions:
In 2006, the Institut de l’administration publique du Québec honoured the TSC team with an award of excellence in the public service category for the quality of its work.
The Trauma Services Continuum (TSC) was born of a partnership between the Ministère de la Santé et des Services sociaux (MSSS) and the Société de l’assurance automobile du Québec (SAAQ), which began in 1992. The scope, effectiveness and efficiency of the practices put in place and the results obtained distinguish the TSC from the organizations and approaches found elsewhere in Canada and abroad. There is no doubt that Québec trauma victims benefit from one of the best systems, and it is TSC’s excellent work and its substantial positive impact that have won this recognition.
One of the Continuum’s strengths is its continuous quality improvement system, which serves to prevent, detect and rectify situations that could jeopardize the quality of care. It is to that end that INESSS trauma team offers its partners the CST Web site, which is a computerized assessment tool that help improve the effectiveness of the current network.
Congratulations to every person and organization that helped make TSC a model of excellence for its peers in the Québec public administration!!