A Novel Mixed Methods Approach to Understanding Priorities in Emergent Traumatic Brain Injury Anesthesia Care.

Area of Science:

• Anesthesiology
• Neurocritical Care
• Quality Improvement

Background:

• Traumatic brain injury (TBI) presents significant mortality risks.
• Optimal anesthesia protocols for TBI patients remain under-researched.
• Understanding provider perspectives is crucial for improving emergent TBI care.

Purpose of the Study:

• To identify anesthesiology provider priorities for improving emergent TBI anesthesia care.
• To explore perspectives using mixed methods, including surveys and focus groups.

Main Methods:

• A mixed-methods approach involving 177 anesthesiology providers (attendings, nurse anesthetists, residents).
• Quantitative analysis of survey and focus group data using word clouds and inductive reasoning.
• Identification of key themes and classification into structure, process, and outcome measures.

Main Results:

• "Timeliness" emerged as the most frequent theme, followed by "standardization," "hemodynamics," and "communication."
• Identified themes aligned with Agency for Healthcare Research and Quality (AHRQ) domains of "effective, equitable, timely, and safe."
• Analysis revealed opportunities primarily in structure-type and process-type quality improvement categories.

Conclusions:

• Mixed-methods analysis effectively identified critical areas for enhancing emergent TBI anesthesia care.
• Prioritizing timeliness, standardization, hemodynamics, and communication can improve TBI patient management.
• The findings provide actionable insights for quality improvement initiatives in TBI anesthesia.