Trauma System Evaluation in Developing Countries: Applicability of American College of Surgeons/Committee on Trauma (ACS/COT) Basic Criteria

Latifi, Rifat; Ziemba, Michelle; Leppäniemi, Ari; Dasho, Erion; Dogjani, Agron; Shatri, Zhaneta; Kociraj, Agim; Oldashi, Fatos; Shosha, Lida

doi:10.1007/s00268-014-2538-7

Cited by 20 publications

(17 citation statements)

References 11 publications

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“…Meanwhile, few attempts have been made to evaluate entire emergency care systems, rather than focusing on abilities of each health facility or EMS alone. Latifi et al used the basic trauma care system criteria of American College of Surgeons, Spiegel et al developed a conceptual model in which surgical care is integrated into health systems and Remick et al developed the Global Trauma System Evaluation Tool (G‐TEST), which indicates a comprehensive model to evaluate the trauma care system. Although these models (particularly G‐TEST) have many aspects in common with the model we developed as some of their components were borrowed, important differences exist.…”

Section: Discussionmentioning

confidence: 99%

“…Their evaluations address physical and human resources, such as equipment, knowledge and skills [13][14][15][16][17][18][19][20][21]. Some attempts have been made to assess emergency care systems in wider contexts, which included leadership, financial issues, political commitment and regulatory mechanisms [22][23][24][25]; however, none of them were comprehensive enough to cover the entire system. Some covered only EMS systems, while others paid little attention to informal systems or aftercare (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Development of an emergency medical system model for resource‐constrained settings

Nakahara

Hoang

Mayxay

et al. 2019

Tropical Med Int Health

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Objectives An emergency care system is an important aspect for healthcare organisations in low‐ and middle‐income countries (LMICs) with a growing burden from emergency disease conditions. Evaluations of emergency care systems in LMICs in broader contexts are lacking. Thus, this study aimed to develop a comprehensive emergency medical system model appropriate for resource‐constrained settings, based on expert opinions. Methods We used the Delphi method, in which questionnaire surveys were administered three times to an expert panel (both emergency medical care providers and healthcare service researchers), from which opinions on the model's components were compiled. The panel members were mostly from Asian countries. In the first round, the questionnaire drew a list of model components developed through a literature review; the panel members then proposed new components to create a more comprehensive list. In the second and third rounds, the panel members rated the listed components to achieve consensus, as well as to remove components with low ratings. Finally, we rearranged the list to improve its usability. Results In total, 32 experts from 12 countries participated. The final model totalled 177 components, categorised into 8 domains (leadership, community‐based actions, emergency medical services, upward referral, definitive care, rehabilitation, downward referral, and evaluation and research). No components needed removal. Conclusions We developed a comprehensive emergency care system model, which could provide a basis to evaluate emergency care systems in resource‐constrained LMICs; however, field‐testing and validation of this system model remain to be done.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development of an emergency medical system model for resource‐constrained settings

Nakahara

Hoang

Mayxay

et al. 2019

Tropical Med Int Health

View full text Add to dashboard Cite

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“…This study focuses only on the in‐hospital non‐trauma centre component of the trauma system. Several other components of the trauma system, like the trauma centres, pre‐hospital care, definitive care facilities, disaster preparedness, finances, research and information systems, are not evaluated, but will be the focus of future assessments …”

Section: Discussionmentioning

confidence: 99%

Implementation of a trauma system in Norway: a national survey

Dehli

Gaarder

Christensen

et al. 2015

Acta Anaesthesiol Scand

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Background: Trauma systems have improved outcomes for injured patients, but might be challenging to implement. We assessed the implementation of a trauma system in Norway after recommendations for a national trauma system were published in 2007, with a focus on elements in acute care hospitals. Methods: All hospitals in Norway, except for the four regional trauma centres, admitting injured patients at the time of the study were included in a telephone survey. The questionnaire was administered during May 2013 by the regional trauma coordinators who interviewed the local trauma coordinator and/or the local doctor responsible for trauma care in all the acute care hospitals. The main categories were availability of the trauma team and team training, written procedures, preparedness and training of personnel. The compliance to a set of 17 predefined trauma system criteria was evaluated at each institution. Results: Of the 35 acute care hospitals in Norway admitting trauma patients at the time of the survey, all were included. The median number of fulfilled criteria was 14. Major deficiencies were found in fulfilling competence criteria, maintaining a local trauma registry, and trauma audits. The number of fulfilled criteria correlated strongly with the size of the hospital and the frequency of trauma team activation. Conclusions: Shortcomings in requirements for lower-level trauma care hospitals correlate to hospital size and frequency with which the trauma team is activated. In order to fulfill the minimum requirements, smaller hospitals should receive more attention.

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“…Trauma injuries cause higher mortality rates compared to AIDS (Acquired immune deficiency syndrome) , Malaria and tuberculosis [3]. The number of deaths caused by trauma is estimated to be 5.8 million per year [4]. The majority of dead people are below 45 years of age [5].…”

Section: Introductionmentioning

confidence: 99%

“…These countries have the highest number of traumatic car accidents. On the other hand, they lack an organized trauma system [4]. Car accidents account for 1 to 15 percent of GDP (Gross domestic product) fall in developing countries [8].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Performance in Trauma Care: experts’ viewpoints

Mousazadeh

Janati

Sadeghi-Bazarghani

et al. 2020

Preprint

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Background: Trauma is one of the leading causes of mortality across the world. Trauma patients had critical status and need timely, adequate and organized care. The different consequences of trauma care among service centers around the world and even within a country reveal the need for care assessment. This study was designed and executed to collect experts’ opinion on the evaluation of trauma care in Iran. Methods: This qualitative study with conventional content analysis approach, two focus group discussions with 12 participants and 16 face-to-face in-depth interviews were conducted to collect the required data. Participants were selected through purposive sampling method. The experts’ viewpoints were classified in accordance with the main and sub themes. Results: Four basic themes extracted from the interviews and focus group discussion including, trauma care importance (sub-themes: the involved Individuals’ being young and productive and the effectiveness of trauma care); trauma care indicators (sub-themes: pre-hospital indicators, in-hospital indicators and post-hospital indicators); stages of trauma care evaluation (sub-themes: evaluation prerequisites, finalization of indicators prior to evaluation, determining evaluation time scope, determining evaluation dimensions, monitoring and evaluation and use of evaluation results); trauma care promotion (sub-themes: balancing workload in trauma centers, enhancement of information system, considering extra-organizational dimensions in trauma care and empowerment of trauma care providers). Conclusion: Performance evaluation through acceptable indicators is basis of health care improvement. In addition to the evaluation, reforming macro policies, development of infrastructures, enhancement of information system and training care providers should be taken into account too. Keywords: Performance indicators, Evaluation, Hospital, Trauma care

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Trauma System Evaluation in Developing Countries: Applicability of American College of Surgeons/Committee on Trauma (ACS/COT) Basic Criteria

Abstract: The ACS/COT basic criteria can be used as assessment tools to evaluate trauma care in developing countries. Further studies are needed in other developing countries to validate the applicability of these criteria.

Cited by 20 publications

References 11 publications

Development of an emergency medical system model for resource‐constrained settings

Development of an emergency medical system model for resource‐constrained settings

Implementation of a trauma system in Norway: a national survey

Evaluation of Performance in Trauma Care: experts’ viewpoints

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