Beliefs and expectations of rural hospital practitioners towards a developing trauma system: A qualitative case study |
| |
| Affiliation: | 1. Queen Mary University of London, London, UK;2. Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, UK;3. University of Greenwich, London, UK;4. Division of Acute Care Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA;1. Department of Orthopaedic Surgery, University of Missouri, Columbia, USA;2. Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, USA;3. Division of Laboratory Animal Resources, University of Pittsburgh, Pittsburgh, PA, USA;1. Department of Orthopaedics, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China;2. Department of Orthopaedic Surgery, Shanghai Tenth People’s Hospital Affiliated to Tongji University, Shanghai 200072, China;3. Institute of Bone Tumor Affiliated to Tongji University, School of Medicine, Shanghai 200072, China;1. Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark;2. Copenhagen University Hospital Hvidovre, Copenhagen, Denmark;1. C.S. of Hand Surgery and Microsurgery, AOU Policlinico of Modena, Modena, Italy;2. I Clinica Ortopedica e Traumatologica, Istituto Ortopedico Rizzoli, Bologna, Italy;3. C.S. of Orthopedic Surgery, Hospital Cardinal Massaia, Asti, Italy;4. University of Modena and Reggio Emilia, Italy;1. Division of Cardiology, Pusan National University Hospital, Busan, Republic of Korea;2. Trauma Center, Pusan National University Hospital, Busan, Republic of Korea;3. Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea;1. Department of War Surgery, Kirov Military Medical Academy, 6 Lebedeva Street, Saint-Petersburg 194044, Russian Federation;2. Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan;3. Department of Radiology, Kirov Military Medical Academy, 6 Lebedeva Street, Saint-Petersburg 194044, Russian Federation;4. R. Adams Cowley Shock Trauma Center, University of Maryland Medical System, 22 S Greene St., Baltimore, MD 21201, USA |
| |
| Abstract: | BackgroundAn understanding of stakeholders’ views is key to the successful development and operation of a rural trauma system. Scotland, which has large remote and rural areas, is currently implementing a national trauma system. The aim of this study was to identify key barriers and enablers to the development of an effective trauma system from the perspective of rural healthcare professionals.MethodsThis is a qualitative study, which was conducted in rural general hospitals (RGH) in Scotland, from April to June 2017. We used an opportunistic sampling strategy to include hospital providers of rural trauma care across the region. Semi-structured interviews were conducted, recorded, and transcribed. Thematic analysis was used to identify and group participant perspectives on key barriers and enablers to the development of the new trauma system.ResultsWe conducted 15 interviews with 18 participants in six RGHs. Study participants described barriers and enablers across three themes: 1) quality of care, 2) interfaces within the system and 3) interfaces with the wider healthcare system. For quality of care, enablers included confidence in basic trauma management, whilst a perceived lack of change from current management was seen as a barrier. The theme of interfaces within the system identified good interaction with other services and a single point of contact for referral as enablers. Perceived barriers included challenges in referring to tertiary care. The final theme of interfaces with the wider healthcare system included an improved transport system, increased audit resource and coordinated clinical training as enablers. Perceived barriers included a rural staffing crisis and problematic patient transfer to further care.ConclusionsThis study provides insight into rural professionals’ perceptions regarding the implementation of a trauma system in rural Scotland. Barriers included practical issues, such as retrieval, transfer and referral processes. Importantly, there is a degree of uncertainty, discontent and disengagement towards trauma system development, and concerns regarding staffing levels and governance. These issues are unlikely to be unique to Scotland and warrant further study to inform service planning and the effective delivery of rural trauma systems. |
| |
| Keywords: | Rural trauma Trauma systems Qualitative research |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
