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Trauma care reference body now woven into DHA combat support

Establishing the Joint Trauma System within the Defense Health Agency optimally positions the JTS to serve as the reference body for all trauma care. (U.S. Navy photo by Petty Officer 1st Class Gary Johnson) Establishing the Joint Trauma System within the Defense Health Agency optimally positions the JTS to serve as the reference body for all trauma care. (U.S. Navy photo by Petty Officer 1st Class Gary Johnson)

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In 2003, the Joint Trauma System began forming when a commander with the U.S. Army Institute of Surgical Research recognized that no formal trauma care standards existed in Iraq and Afghanistan. Reports showed medical care as well-documented in theater, but critical patient information wasn’t readily available as a wounded member moved through multiple hospitals. At the time, deployed medical teams mostly relied on phone call coordination for long-term follow-up treatments for the wounded.

Air Force Col. Jeffrey Bailey – incoming Joint Trauma System, or JTS, director – said establishing the JTS within the Defense Health Agency, or DHA, “optimally positions the JTS to serve as the reference body for all trauma care.” The transition officially takes place on Aug. 5.

According to Dr. Donald Hall, chief of staff to the assistant director, DHA Combat Support Agency, the transition is advantageous because it will enable JTS to influence decisions directly and unfiltered on a day-to-day basis. “We’re looking forward to the synergy gained by having them become part of the combat support agency,” Hall said.

Today DHA helps enable medical services of the Army, Navy, and Air Force to provide combatant commands, or COCOMs, with a medically ready force and ready medical force. With JTS part of the DHA, DHA can better “establish standards of care for trauma services provided at military treatment facilities,” said Bailey, who has most recently spent time serving as a consultant to the United States Air Force Surgeon General for trauma and surgical critical care, and as special assistant to the Assistant Director, Combat Support Agency, Defense Health Agency. Bailey added that the JTS coordinates standards for trauma care, along with translating research findings, trauma education, and training partnerships.

Today, the JTS mission is to provide evidence-based process improvement of trauma and combat casualty care to drive morbidity and mortality to the lowest possible levels, and to provide recommendations on trauma care and trauma systems across the Military Health System. The JTS works proactively with COCOM surgeons as they develop contingency plans for a trauma system that supports unique COCOM mission requirements.

Another component of the JTS is the DoD Trauma Registry, or DoDTR. The DoDTR is an electronic data repository for Department of Defense trauma-related injuries. It captures combat casualty care epidemiology, treatments, and outcomes from point of injury to recovery. Classifying information taken from medical records, the DoDTR serves as an expert clinical inference, scoring and coding schematics with probability determinations.

The DoDTR contains more than 84,000 individual patient injury events, with more than 135 thousand trauma records.

“The DoDTR is the living reference body of our trauma care experience, the backbone of all we do to improve injury survival and recovery,” said Bailey. “It will continue to benefit those we serve in the years to come."

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