Cycling-related injuries and cycling promotion: A trauma service perspective. Singh, N., Joe, N., Amey, J., Smith, A., Christey, G. (2019) The New Zealand Medical Journal, Vol 132, No. 1494 / 7868.
Aim: Current policy direction seeks to promote participation in both recreational and active transport cycling. We evaluate cycling-related injuries resulting in hospital admission across the Midland Region of New Zealand to establish injury trends. Conclusion: Hospital admission volumes and rates are rising with underlying variation in patient demography, place and severity of injury. Current policy direction to grow cycling participation based on the health, environmental and economic benefits is ahead of the implementation of safer cycling infrastructure, creating a timing lag. From a regional hospital-based trauma service perspective, this timing lag needs due consideration if the full benefits of increasing participation are to be realised.
|TV Interviews with Grant Christey||TV1 Breakfast (recap on evening news): https://www.tvnz.co.nz/one-news/new-zealand/injured-cyclists-admitted-hospital-rise-significant-issue-could-cost-millions-doctor-says
AM Show (TV3) + MagicTalk radio: https://www.newshub.co.nz/home/new-zealand/2019/05/infrastructure-not-keeping-up-with-cycling-boom-researcher.html
TV3 The Project – replayed some of the interview with Grant. They then interviewed the Associate Minister of Transport Hon Julie Anne Genter about cycling safety plans.
|Radio Interviews with Grant Christey||Radio NZ nine-to-noon: https://podcast.radionz.co.nz/ntn/ntn-20190503-0908-cycling_injuries_rise_dramatically_-_what_can_be_done-128.mp3|
|Radio discussions on the topic||Radio NZ afternoons (the panel, where cycling safety was the question of the day): https://podcast.radionz.co.nz/panel/panel-20190503-1631-question_of_the_day_for_3_may_2019-128.mp3|
|Online newspaper articles||Stuff – national news: https://www.stuff.co.nz/national/health/112413955/health-cost-in-promoting-cycling-without-safety-provisions-trauma-study
NZ Herald: “cyclists back Midland Trauma’s safety criticisms in injury report” https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=12227394
|Print newspaper articles||Dominion Post (page 2) - article included talking with local cyclists and advocacy groups
Waikato Times – Weekend (front page). Article included comments from a Hamilton City Council infrastructure manager and a City Councillor
Improving patient experience and outcomes following serious injury. Beaton, A., O'Leary, K., Thorburn, J., Campbell, A., Christey, G. (2019) The New Zealand Medical Journal, Vol 132, No. 1494 / 7866.
Aim: To explore injured patients’ experiences of care to identify areas for improvement in routine service delivery from surgical teams in the transition from inpatient to community-based care. Conclusion: This study highlights perceived issues in the patient care pathway in the transition from inpatient to community-based care, especially communication and discharge information provided by surgical clinical teams and Accident Compensation Corporation (ACC). Comprehensive inpatient care and clinical handover to primary care (rather than discharge planning processes) by dedicated clinical trauma services may provide more holistic models for surgical services to improve their influence on the transition of trauma patients into the community, assisted by organisation changes and support to enable effective service delivery. Specifically, trauma patients and their carers perceived the need for better screening and treatment for psychological trauma in the inpatient and outpatient setting; better information exchange prior to the transition from inpatient to primary care; more convenient and accessible follow-up services including a single point of contact for coordination of post-discharge care; and acknowledgement and practical support to relieve the significant and pervasive carer burden identified in this study. These findings provide the opportunity to implement focused system changes to provide more equitable and effective support in the transition to community care and beyond. The end result will be better experiences for patients and whānau, and improved health and vocational outcomes following serious injury.
The epidemiology of work-related injury admissions to hospitals in the Midland region of New Zealand. Kool, B.; Ameratunga, S., Scott, N., Lawrenson, R., Christey, G. (2017). Injury, Vol. 48, p2478-2484.
Aim: To describe the epidemiological characteristics of patients with work-related injuries (WRI) admitted to hospitals in New Zealand's Midland Trauma System (MTS) durina a four year period. Conclusion: Work-related injuries are a preventable cause of harm and health inequities in New Zealand, and targeted by the Government for a reduction of 25% by 2020. Characteristics of WRI in the Midland Region of New Zealand identified in this study may assist in identifying areas for intervention.
Characteristics of older adults hospitalised following trauma in the Midland region of New Zealand. O’Leary, K., Kool, B., Christey, G. (2017). New Zealand Medical Journal, Vol. 130, No. 1463, p45-53.
Aim: To describe the epidemiology of injuries sustained by older adult trauma patients admitted t hospitals in the Midland Region (population 886,000) of New Zealand. Conclusion: These findings illustrate the growing volumes and changing epidemiology of both major and minor trauma affecting older persons hospitalised following trauma in one of the four health regions of New Zealand. There is a need to prepare for an increase in demand for trauma services to meet the needs of an ageing population in New Zealand.
Ten-year experience of splenic trauma in New Zealand: the rise of non-operative management. Alamri, Y., Moon, D., Ah Yen, D., Wakeman, C., Eglinton, T., Frizelle, F. (2017). New Zealand Medical Journal, Vol. 130, No. 1463, p11-18.
Aim: The aim of this study was to describe the demographics, mechanisms of injury, management and outcomes in patients who suffered splenic trauma in Christchurch, New Zealand. Conclusion: Splenic injuries have shown a steady increase in the last decade. Spenectomy rates have decreased in favour of non-operative techniques. Radiological intervention with splenic artery embolisation was successful in all selected patient with high-grade injuries.
Monitoring pre-hospital transport of severely injured patients in the Midland Region of New Zealand. Whitehead, J., Roskruge, M., Tan, C., Smith, A., Christey, G. (2018). New Zealand Medical Journal, Vol. 131 No. 1470, p71-78.
Aim: Pre-hospital triage strategies aim to identify the type and extent of patient injuries and ensure that they are transferred to the most appropriate trauma centres. Despite the importance of appropriate pre-hospital transport, there is little evidence base to assist medical staff on optimal destination policy for emergent pre-hospital transport. This paper explores the spatial relationship of patient transfers prior to the implementation of the Midland Pre-Hospital Trauma Destination Matrix in New Zealand, and is a retrospective view of practice against a destination policy that was applied after the study period. Consclusion: Approximately one-third of patients were not directly transported to the preferred definitive care hospital subsequently defined in the Midland Pre-Hospital Trauma Destination Matrix. Ongoing monitoring of the pre-hospital transportation system and the implementation of a formal pre-hospital transport policy may improve the efficiency of the Midland Trauma System. Future studies should examine the possible reasons for variations in triage decisions across the Midland Region.
Equine-related injuries requiring hospitalisation in the Midland Region of New Zealand: a continuous five-year review. Jones, A. R., Smith, A., & Christey, G. (2018). The New Zealand Medical Journal, Vol. 131 No. 1483, pg50-58.
Aim: To examine the pattern and outcomes of equine-related injuries for hospitalised patients in the Midland Region of New Zealand over a five-year period. Conclusion: The study has identified the demography, injury types, risk factors and outcomes for equine-related injuries in the Midland Region of New Zealand. Indications are that the severity of such injuries may be less than previously reported. However, the volumes and costs of injury represent a significant burden on the health system, individuals and communities. More detailed understanding of causative factors will allow targeting of prevention strategies to address high-risk activities and demographic groups.
Livestock-related injuries in the Midland region of New Zealand. Tosswill, M., Roskruge, M., Smith, A., & Christey, G. (2018). The New Zealand Medical Journal, Vol. 131 No. 1483, pg13-20.
Aim: To assess the incidence and patterns of injury resulting from force transferred from large livestock in the Midland Region of New Zealand, and to identify foci for prevention. Conclusion: This study has identified high-risk animals, activities, age intervals and times during which large livestock-related injuries may occur, and revealed the significant impact on hospitals and communities that these injuries result in.
Audit of ethnicity data in the Waikato Hospital Patient Management System and Trauma Registry: pilot of the Hospital Ethnicity Data Audit Toolkit. Scott, N., Clark, H., Kool, B., Ameratunga, S., Christey, G., & Cormack, D. (2018). The New Zealand medical journal, Vol. 131, No. 1483, p21-29.
Aim: To audit the quality of ethnicity data captured by the Waikato Hospital Trauma Registry and Waikato Hospital patient management system against self-identified enthnicity. Conclusion: The degree of misclassification of Maori ethnicity data among patients in the Waikato Trauma Registry and the Waikato Hospital patient management system highlights a need for improvements to how ethnicity data is captured within these databases and potentially many other similiar entities collecting enthnicity data in New Zealand. The release of revised standardised protocols for the collection of ethnicity data is timely given the recent establishment of a national trauma registry. Without quality data, the opportunity to investigate and address ethnic inequities in trauma incidence and management is greatly compromised.
The New Zealand Major Trauma Registry: the foundation for a data-driven approach in a contemporary trauma system. Isles, S., Christey, G., Civil, I., Hicks, Hicks, P. (2017). The New Zealand Medical Journal, Vol. 130, No.1463, p19-27.
Aim: to describe the development of the New Zealand Major Trauma Registry (NZ-MTR) and the initial experiences of its use. Conclusion: Despite the challenges working across multiple jurisdictions, initiation of a single-instance web-based registry has been achieved. The NZ-MTR enables New Zealand to have a national view of trauma treatment and outcomes for the first time. It will inform quality improvement and injury prevention initiatives and potentially decrease the burden of injury on all New Zealanders.
Psychiatric comorbidities in adult survivors of major trauma: findings from the Midland Trauma Registry. Spijker, EE., Jones, K., Duijff, JW., Smith, A., Christey, G. (2018). Royal New Zealand College of General Practitioners, Vol.10, No.4, p292-302.
Aim: To determine the extent to which adults' experience impaired health-related quality of life (QoL), symptoms of post-traumatic stress disorder, depression, chronic pain and harmful alcohol use during the year following major trauma, and to identify factors associated with outcomes. Conclusion: A significant proportion of adults experience adverse psychosocial outcomes in the first year following major trauma. Screening and management of potentially comorbid psychosocial needs could improve care and outcomes for survivors.
Quad bikes injuries in Waikato, New Zealand: an institutional review from 2007-2011. Wood, A., Duijiff, JW., Christey, G. (2013) ANZ Journal of Surgery, Royal Australasian College of Surgeons, Vol 83, p206-210.
Aim: The aim of this study was to assess the burden of all-terrain vehicle (ATV) injuries within the Waikato region of New Zealand. Conclusion: Quad bike injuries are an increasing burden on Waikato health care. The best strategy to tackle this epidemic needs to be further debated.
2017-2020 Midland Regional Services Plan (Strategic Direction)
Defining major trauma using the 2008 AIS Palmer Gabbie Cameron
Improved Functional Outcomes for Major Trauma Patients in a Regionalized Inclusive Trauma System
Mortality by cause for eight regions of the world Global Burden of Disease Study
Reduced Population Burden of Road Transport related Major Trauma After Introduction of an Inclusive Trauma System
Trauma Care in New Zealand It is Time to Move Ahead
Victoria Trauma Care - patient survival, Gabbe et al
Quad bike injuries in Waikato, New Zealand: an institutional review from 2007–2011
Incidence of traumatic brain injury in New Zealand: a population-based study (2012) Feigin, Theadom et al, for the BIONIC Study Group