Trauma is a significant burden to the Australian economy. In 2017 the Australian Automobile Association estimated the cost of road trauma alone at $30 billion a year, up from 27 billion in 2006. The Australian Trauma Registry (ATR) was first launched in 2011 under the auspices of the Australian Trauma Quality Improvement Program (AusTQIP), a program that brought together in-hospital trauma data from all major trauma centres in Australia through the AusTQIP Collaboration Agreement.
Although the ATR became official in 2011 the need for a national trauma registry in Australia was initially flagged in 1993 by the National Road Trauma Advisory Council (NTRC) in conjunction with support from the Royal Australasian College of Surgeons (RACS) and the Australasian Trauma Society (ATS). This early advocacy, combined with financial support from the Centre of National Research on Disability and Rehabilitation Medicine (CONROD), formed the basis for the formation a decade later of the Australian and New Zealand National Trauma Registry Consortium (NTRC), led by Mr Cliff Pollard FRACS. In 2003 CONROD and the New South Wales Institute of Trauma Injury Management (ITIM), with support from RACS and the ATS provided funding to collate in-hospital trauma data from available sources in Australia and New Zealand, producing annual reports in 2003, 2004 and 2005.
During this time and for the next five years the NTRC committed to the task of standardising trauma data collection to enable benchmarking and deploying a trauma minimum dataset that would serve both Australia and New Zealand. This work, which began in 2005 was completed in 2010 with the development of a dictionary comprising 67 data elements. The dataset is now known as the Bi-National Trauma Minimum Dataset (BNTMDS).
The NTRC ceased operations while the development of the BNTMDS was in progress, however the decades of support and commitment shown to the concept of a national trauma registry, and the eventual availability of an agreed MDS, laid a firm foundation for the next phase of development - the Australian Trauma Quality Improvement Program and the Australian Trauma Registry (AusTQIP-ATR).
In 2011, lobbying of the RACS, and funding from Alfred Health in Melbourne and the National Critical Care and Trauma Response Centre (NCCTRC) in Darwin enabled the NTRC’s work to continue and to the formation of AusTQIP. Under AusTQIP all major trauma centres agreed to provide trauma data as per the BNMTDS through the signing of the AusTQIP Collaboration Agreement. Between 2011 and 2014 AusTQIP strengthened the ATR and collected data from the majority of major trauma centres in Australia from 2010 to 2012, producing the first consolidated report in 2014. After this funding ceased.
In 2015 funding from Alfred Health allowed the ATR to be continued for a short time whilst funding was secured. In May 2016, the Senate enquiry into Aspects of road safety in Australia made seventeen key recommendations, the first of which was to recommend that the Commonwealth Government commit to funding the operation of the Australian Trauma Registry. This prioritisation of registries with capacity to influence care was supported by the Royal Australasian College of Surgeons. In addition, in November 2016, the Australian Commission on Safety and Quality in Health Care prioritised trauma in its second highest clinical domain for clinical quality registry development .
In December 2016, the Prime Minister Malcolm Turnball, concerned about the number of Australians killed on the road and responding to the above recommendations, announced new funding for the Australian Trauma Registry to allow it to accurately track the progress of major injuries through the major trauma centres in Australia. Commonwealth funding was provided by the Department of Infrastructure, Regional Development & Cities, Bureau of Infrastructure, Transport and Regional Economics and the Department of Health.
The ATR as we know it has now been been operating since 2012 and has been joined by New Zealand. It has collated data from Australia since 2010, and in 2019 will produce data including New Zealand. We look forward to continuing to operate to continue our mission and improve caring for the injured, and encourage all clinical researchers, governments and policy makers to make us of this data.
Please see recently published paper Fitzgerald MC, CurtisK, Cameron PA, Ford JE, Howard TS, Crozier JA, Fitzgerald A, Gruen RL & Pollard C on behalf of the AusTQIP Collaboration (2018) The Australian Trauma Registry. ANZ J Surgery (In Press)