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What effect has the major trauma network had on perceptions of trauma care delivery amongst trauma teams in major trauma centres and neighbouring trauma units?

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

The Trauma network was established in April 2012 in England to improve the care of patients with trauma. The care of major trauma was centralised to major trauma centres. This article aims to survey trauma team members (TTM) to compare perceptions of trauma care delivery in major trauma centres (MTC) and trauma units (TU) from where major trauma care has been diverted.

Methods

Trauma team members (TTM) from six hospitals were interviewed between June and July 2016. This included three MTCs and their neighbouring TU. Data were also gathered to determine appropriate trauma qualifications of TTMs.

Results

TTMs in MTCs perceived the standard of trauma service improved (90% increased, 10% same) since April 2012 in comparison to TUs (10% increased, 63% same, 27% decreased) (p ≤ 0.001). In MTCs, TTMs felt their skills improved more (66% improved, 34% unchanged) compared to TU’s (24% improved, 64% unchanged, 12% regressed) (p ≤ 0.001). TTM’s in MTCs were more satisfied with their trauma teams training (p ≤ 0.001), leader’s communication (p ≤ 0.001) and handover process (p ≤ 0.01) in comparison to TTMs in TUs. 69% of doctors in MTCs held valid trauma qualifications as compared to only 37% in TUs (p ≤ 0.001).

Conclusion

The centralisation of major trauma care to MTCs allows care for severely injured patients in specialised hospitals with allocated resources. This survey shows the effect of this reorganisation where diversion of major trauma from TUs may have led to their TTMs perceiving their standard of care to be less than TTMs in MTCs. This study recommends training support for TUs using modalities such as simulation-based training and regular audits to ensure improved perceptions and adequate qualifications. Multidisciplinary meetings between MTCs and TUs can allow information to be exchanged and shared to ensure reciprocal support and engagement to improve perception of trauma care delivery.

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Acknowledgements

MF: data collection—Doncaster ST7 General Surgery. BE data collection—ST6 Trauma and Orthopaedics. BD: data collection—ST5 Trauma and Orthopaedics. JR: data collection—ST4 Trauma and Orthopaedics. CC: data collection—Leeds General Infirmary CT3 Plastics. KH: data collection—FY2 Trauma and Orthopaedics.

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Authors and Affiliations

  1. Pindersfields General Hospital, Wakefield, UK

    Osman Riaz & Manjit Bhamra

  2. Leeds General Infirmary, Leeds, UK

    Syed Bokhari, Nayef Aslam-Pervez, Zain Sadozai & Paul Harwood

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  1. Syed Bokhari
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  2. Nayef Aslam-Pervez
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Correspondence to Osman Riaz.

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All the authors in this study declare that they have no conflict of interest.

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Bokhari, S., Aslam-Pervez, N., Riaz, O. et al. What effect has the major trauma network had on perceptions of trauma care delivery amongst trauma teams in major trauma centres and neighbouring trauma units?. Eur J Trauma Emerg Surg 47, 171–177 (2021). https://doi.org/10.1007/s00068-019-01206-1

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