Trauma care continuum (TCC)

The trauma care continuum (TCC) is the organizational model for trauma care and services in Québec. It is an integrated services network for trauma victims designed to ensure that all victims receive the personalized services they need depending on the complexity and severity of their injuries. The goal of the TCC is continuous improvement in the accessibility, efficiency, quality and continuity of the care and services provided to those injured.

This unique model depends on cooperation within the health and social services network and sharing of responsibility among many partners. The goal is rapid access across Québec to top quality care and services adapted to patients’ injuries regardless of geographic location or sociodemographic profile.

The main objective of the TCC is to ensure the accessibility, efficiency, quality and continuity of trauma care and services:

  • Accessibility: the network must provide immediate comprehensive care to any victim of severe or potentially severe trauma. This means integration of services, from pre-hospital emergency services to hospital and then post-hospital services.
  • Efficiency: reducing wait times is a top priority in traumatology to ensure the best chances of patient survival. Tools have been developed to facilitate pre-hospital triage and destination decisions. Hospital and post-hospital procedures and protocols have also been developed to enable better organization and coordination of activities and resources.
  • Quality: all actions in the chain of interventions (pre-hospital to post-hospital) are defined by procedures and protocols shared and recognized by all stakeholders in the trauma services network. Local committees also play a key role in continuously improving quality by continuous monitoring of trauma care activities in their jurisdictions and selective review of trauma cases. Mechanisms for consultation/cooperation among the different levels of action (local, regional and national) have been established to ensure unified efforts to achieve goals. Evaluation measures make it possible to sustain continuous quality improvement in the TCC.
  • Continuity: the TCC must allow all patients access to specialized and subspecialized care regardless of their geographic location or the severity or complexity of their injury. To this end, two-way service corridors and administrative agreements have been established to facilitate patient transfer to the appropriate facility, and the right to refuse has been abolished for designated trauma centres.

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