User-Centered Design of Trauma Systems Solutions for Retriage of Patients With Injury: Mixed Methods Study

Area of Science:

• Medical Informatics
• Trauma Surgery
• Health Systems Engineering

Background:

• Retriage involves transferring severely injured patients from lower-level to high-level trauma centers.
• An estimated 17%-34% of trauma patients are undertriaged, facing significantly higher mortality risks.
• Despite undertriage, 30%-50% of these patients never receive necessary retriage, highlighting a critical care gap.

Purpose of the Study:

• To develop a digital health solution using user-centered design to improve the patient retriage process.
• To address obstacles hindering timely and effective interhospital transfers of severely injured patients.

Main Methods:

• A 5-phase user-centered design approach was employed, involving frontline users and hospital leadership.
• Methods included site observations, focus groups, ideation, prototyping, and validation of digital solutions.
• Thematic analysis focused on robustness, acceptability, and feasibility, anchored in design thinking principles.

Main Results:

• User-centered design engaged 49 participants from 12 trauma centers across 5 phases.
• A centralized, systemwide bed tracker with hourly updated availability was identified as the optimal solution.
• Resource transparency between centers emerged as a key design requirement.

Conclusions:

• A 5-phase user-centered design process yielded a digital bed tracker solution.
• This informatics tool provides frequently updated bed availability at high-level trauma centers.
• The developed bed tracker aims to enhance the retriage process for patients with traumatic injuries.