Enhancing Trauma Care in Tertiary Hospitals: Addressing Gaps and Pathways to Improvement

Area of Science:

• Public Health
• Trauma Care Systems
• Healthcare Management

Background:

• Trauma is a leading global cause of death, with road traffic accidents projected to increase significantly.
• Developing countries, such as Pakistan, face unique challenges in providing effective trauma care.
• Tertiary care hospitals in Pakistan's twin cities were evaluated for trauma management effectiveness.

Purpose of the Study:

• To assess the current state of trauma centers in tertiary care hospitals in Islamabad and Rawalpindi.
• To identify gaps and challenges in trauma patient management within these facilities.
• To provide data-driven recommendations for improving trauma care delivery in Pakistan.

Main Methods:

• A descriptive cross-sectional study design was employed.
• The World Health Organization's Hospital Emergency Unit Assessment Tool (HEAT) was utilized.
• Data were collected from five major public sector hospitals through key informant interviews and protocol reviews.

Main Results:

• While emergency services, operating rooms, and labs were available 24/7, critical equipment like portable X-rays (40%) and RDT/HIV testing (20%) showed low availability.
• Eighty percent of hospitals had clinical management protocols, but only 20% had specific protocols for critical conditions like asthma exacerbation and maternal hemorrhage.
• Infrastructural deficiencies and systemic barriers were identified as significant contributors to inadequate trauma care.

Conclusions:

• Significant gaps exist in Pakistani trauma care, including personnel shortages, infrastructure deficits, and a lack of standardized protocols.
• Urgent systemic improvements are needed, including increased investment, enhanced staffing and training, and protocol standardization.
• This study offers novel insights into barriers in Pakistan's trauma care system, informing targeted reforms to reduce morbidity and mortality.