Developing a pediatric trauma system in Tuscany, Italy: a case study in transformative change

J Trauma. 2011 Nov;71(5):1442-6. doi: 10.1097/TA.0b013e31820f926f.

Abstract

Background: Trauma is the leading cause of death and disability in Italy among patients aged between 1 year and 19 years. To transform its fragmented regional pediatric trauma system to a more organized and efficient spoke and hub model, Tuscany has developed a partnership with physicians from the United States to facilitate the process and to implement a series of strategic system changes to create the first pediatric trauma center in Italy.

Methods: After establishing a multidisciplinary and institutional task force, a rigorous needs assessment was conducted to evaluate resources and develop a strategic timeline with specific project goals. Once an intensive educational program was completed, a series of system changes were made in Tuscany to create a full-service pediatric trauma center. Once accomplished, regional changes were enacted to divert the most severely injured children to the new center.

Results: In <3 years, a full-service pediatric trauma center was developed and ingratiated into the adult trauma system. All these changes were achieved through relentless administrative support, creation of a strong sense of urgency, and empowerment of innovators and early adopters to effect change.

Conclusion: Through a comprehensive process including early extensive system analysis leading to educational interventions and organizational changes, the Anna Meyer Children's Hospital has developed the first Italian pediatric trauma center.

MeSH terms

  • Emergency Medicine / education
  • Humans
  • Inservice Training
  • International Cooperation
  • Italy
  • Needs Assessment
  • Organizational Innovation*
  • Patient Care Team / organization & administration
  • Pediatrics / education
  • Pediatrics / organization & administration*
  • Planning Techniques
  • Trauma Centers / organization & administration*
  • United States