Defining the bellwether procedures and processes for global trauma care: an international Delphi study.

Area of Science:

• Global Health
• Trauma Surgery
• Healthcare Quality Assessment

Background:

• Assessing global trauma care provision is challenging due to its complexity.
• Existing methods for evaluating surgical care lack a trauma-specific equivalent.
• This study aimed to establish bellwether procedures and processes for global trauma care assessment.

Purpose of the Study:

• To identify and define key indicators for assessing global trauma care capabilities.
• To establish a consensus on essential procedures and processes in trauma management.
• To provide a framework for evaluating and improving trauma care standards worldwide.

Main Methods:

• A global Delphi process involving healthcare professionals and academics in trauma care.
• Literature review and expert opinion to identify potential procedures and processes.
• Three rounds of expert rating using a five-point Likert scale to determine consensus.

Main Results:

• 411 respondents from 78 countries participated in the Delphi process.
• Nine bellwethers of global trauma care were identified across three categories: Resuscitation & Stabilisation, Diagnosis & Monitoring, and Optimisation & Intervention.
• Specific bellwethers include Advanced Airway Management, FAST Scanning, Blood Transfusion, and Laparotomy/Splenectomy.

Conclusions:

• The study successfully established nine pragmatic metrics for assessing global trauma care.
• These bellwethers can guide healthcare settings, managers, and ministries in identifying areas for improvement.
• The findings facilitate enhanced standards in the management of traumatic injuries globally.