ABSTRACT
During Operations Telic and Herrick, a trauma governance system developed that proved the effectiveness of the rapid developments in clinical trauma practice and continues to be the bedrock of research within the Defence Medical Services (DMS). The chapter discusses the role of clinical governance (CG) in identifying good practice, as well as poor, in guiding changes in the management of groups of patients as well as individuals and in identifying priorities for research and development. It provides a further update and demonstrates how weaknesses in performance could be rapidly identified and resolved by instigating guidelines, training, or equipment changes. It has been noted that traditional trauma scoring methods, such as trauma score-injury severity score and a severity characterisation of trauma were developed prior to chaos theory and use linear statistical methods which are not effective at analysing complex systems with many variables such as trauma.
