The state of Victoria, Australia (population 5.6 million) implemented the Victorian State Trauma System (VSTS) ( between 2000 and 2003. The VSTS encompasses all 138 trauma-receiving hospitals in the state, designated according to capability. Three hospitals (two adult, one paediatric) were designated as major trauma services (Level 1 trauma centre equivalent). A single ambulance service (Ambulance Victoria) provides road and air (fixed wing and helicopter) transport of patients. The VSTS delivers inclusive and regionalised trauma care including designation of a small number of major trauma services, pre-hospital triage guidelines allowing bypass of smaller centres in favour of direct transport to the specialist major trauma services hospitals, agreed inter-hospital transfer guidelines, quality assurance programs, a state-wide monitoring system and a governance system capable of impacting change.

The VSTS has been recognised by the World Health Organisation (WHO) as one of the most highly developed and integrated trauma systems in the world, and it has resulted in significant reductions in deaths and improved outcomes for the injured. The system works to have “the right patient delivered to the right hospital in the shortest time” using an integrated referral and education program (

The Alfred was a key contributor in developing the Victoria system. The Alfred and the National Trauma Research Institute have subsequently delivered programs in trauma system development and capacity building in China, Ethiopia, India, Iran, Myanmar, Papua New Guinea, the Philippines, Qatar and Sri Lanka.