The characteristics, history and implementation of Québec’s Trauma Care Continuum (1991-2012)

The trauma care continuum (TCC) is a model for organizing integrated services for victims of moderate to severe trauma. The main objectives of this program, which was set up in Québec in the early 90s, are the accessibility, continuity, efficacy and quality of the services intended for victims of moderate to severe trauma. The TCC follows a number of guiding principles that enjoy international consensus, such as the principle of time dependence, the concept of reverse burden of proof, and the concept of regionalization, this using an integrated, system-wide approach.

The analysis of the history of the TCC and of the factors that facilitated its implementation has led to a number of observations and thoughts. The lessons drawn mainly concern the governance-related aspects, in particular, leadership, and factors pertaining to the development of a learning culture. This has contributed to making players in the field of trauma more amenable to change, in addition to contributing to innovation uptake following the development of an individual and group learning process.

The management of the TCC has been evolving for more than five years. Discussions are taking place about the overall change in the TCC’s organization, in particular, in connection with the mechanisms for concerted action, trauma research and the assessment process put in place with the TSCAF.