Department of Health Policy and Management, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
J Inj Violence Res. 2021 Jul;13(2):99-110. doi: 10.5249/jivr.v13i2.1589. Epub 2021 Apr 24.
Trauma is one of the major causes of mortality across the world. Trauma patients have critical status and need timely, adequate, and organized care. The different consequences of trauma care among service centers around the world and even within a country revealed the need for careful evaluation. This study was designed and executed to collect experts' opinions on the evaluation steps, related indicators, and improvement strategies in trauma care.
This qualitative study was based on a conventional content analysis approach. 2 focus group discussions (FGD) with 6 participants per FGD and 16 face-to-face in-depth interviews were conducted to collect the required information (from September 2018 to early 2019). Participants were selected through the purposive sampling method. The experts' viewpoints were classified by the main and sub themes.
Four basic themes extracted from the interviews and focus group discussions including, trauma care importance (sub-themes: the involved individuals' being young and productive and the effectiveness of trauma care); trauma care indicators (sub-themes: pre-hospital indicators, in-hospital indicators, and post-hospital indicators); stages of trauma care evaluation (sub-themes: evaluation prerequisites, finalization of indicators before the evaluation, determining evaluation time scope, determining evaluation dimensions, external and internal evaluation and use of evaluation results); trauma care improvement (sub-themes: balancing workload in trauma centers, enhancement of information system, considering extra-organizational dimensions in trauma care and empowerment of trauma care providers).
According to experts' viewpoints, trauma is a very important issue, because it involves young people. They believed that having indicators covering all aspects of care assist health managers and policymakers to understand under-standard performance. These indicators should be used in the form of a specific evaluation program and related to Iran context. Besides, reforming macro policies, planning, development of infrastructures, and education was some recommendations of experts to improve trauma care.
创伤是全球范围内导致死亡的主要原因之一。创伤患者病情危急，需要及时、充分、有组织的护理。世界各地乃至一个国家内不同服务中心的创伤护理结果差异表明，需要对其进行仔细评估。本研究旨在收集专家对创伤护理评估步骤、相关指标和改进策略的意见。
本定性研究基于传统的内容分析法。我们进行了 2 次焦点小组讨论（每组 6 人）和 16 次面对面深入访谈，以收集所需信息（2018 年 9 月至 2019 年初）。参与者通过目的抽样法选择。专家观点按主要和次要主题进行分类。
访谈和焦点小组讨论中提取出 4 个基本主题，包括创伤护理的重要性（涉及个人年轻且富有生产力和创伤护理的有效性）；创伤护理指标（包括院前指标、院内指标和院后指标）；创伤护理评估阶段（包括评估前提、评估前确定指标、确定评估时间范围、确定评估维度、外部和内部评估以及评估结果的使用）；创伤护理改进（包括平衡创伤中心的工作量、加强信息系统、考虑创伤护理的组织外维度以及增强创伤护理提供者的能力）。
根据专家观点，创伤是一个非常重要的问题，因为它涉及年轻人。他们认为，拥有涵盖护理各个方面的指标有助于卫生管理者和政策制定者了解不达标的表现。这些指标应作为特定的评估方案使用，并与伊朗国情相关。此外，专家建议改革宏观政策、规划、基础设施发展和教育，以改善创伤护理。
