Presented by Dr Ailene Fitzgerald

Presentation Synopsis: Traumatic injury remains the leading cause of death and disability in the younger age groups worldwide. It also accounts for a significant burden to society in, not only cost of hospitalisation as a direct result of the trauma, but in long-term rehabilitation and ongoing medical costs as well as lost work years. Whilst injury isn’t the leading mortality cause in the geriatric population, geriatric trauma is becoming an increasing burden on our health system and accounts for higher mortality in this age group compared to the younger.

To effectively manage this major public health issue, systems of care have evolved over many decades. Much debate has occurred and indeed continues, regarding the composition, capacity and efficacy of these systems. It is imperative to understand the evolution of these systems in order to examine the way forward. History shows us that a trauma system’s purpose and scope has changed over time. In the 1970s the US developed a system largely aimed at preventing unnecessary deaths in the multiply injured. This evolved over the next 20 years into a system more aimed at optimal recovery goals with measures of effectiveness including such things as timeliness of care, quality and patient satisfaction rather than the traditional outcome measures such as inpatient mortality. Economic pressures and politics also play a major role in the development of such systems.

This presentation aims to review the literature and lessons learnt over many decades of both civilian and military trauma system development and examine possible implications for the future direction of trauma care in Australia.

Bio: Dr Ailene Fitzgerald is a General/Trauma Surgeon and current Director Trauma Service Canberra Hospital since 2012. She chairs the ACT Trauma Committee, is the regional representative for ACT on the RACS Trauma SubCommittee, Deputy Chair of RACS ACT, a Health Expert advising the ACT Liquor Advisory Board and is a member of the Institute for Trauma and Injury Management Clinical Review Committee (ITIM CRC).

Ailene also has a keen interest in surgical education and welfare of junior medical officers and is the supervisor of non-accredited surgical registrars at Canberra Hospital. At a national level, she instructs on Early Management of Severe Trauma and Definitive Surgical Trauma Care courses and regularly contributes as faculty to Australian Trauma Conferences.

Ailene is also active as a Commander in the Navy Health Reserves having joined the Royal Australian Navy in 1991 as an undergraduate medical student. She served in a number of establishments and ships, and completed a number of deployments prior to transferring to the Reserves in 2000 to pursue surgical training. She remains active in the Navy Health Reserves as the Assistant Professional Liaison Officer for Navy Surgeons.