A qualitative interview study among clinicians managing trauma patients: identifying barriers and potential solutions to improving a trauma registry in a lower-to-middle-income country

Abstract

Background The ability to adapt clinical management of trauma in many lower- and middle- income countries (LMICs) has been historically constrained by nonexistent or inadequate data registries. These registries suffer from a variety of issues including administrative, logistical, educational, feasibility, and financial barriers. Objective The present study aimed to survey physicians at a representative hospital with documented trauma record deficiencies regarding their experiences with the current registry system, barriers that affect the current system, and recommendations for improvement. Methods This study was a qualitative analysis of the experiences and opinions of trauma physicians in the Emergency Department of Beni-Suef University Hospital. Eight participants underwent a semi-structured interview covering the aforementioned topics. The interviews were then coded to identify prominent themes, from which quotes that epitomized these themes were selected. Results The participants identified issues with the current data registry system that corroborates prior quantitative data at the location, particularly stressing the lack of critical information affecting patient care and safety including mechanisms of injury, patient identification information, and time courses. Clinical duties and staffing were identified as primary barriers as the large patient volume seen in under-resourced hospitals precludes the ability of the physician to adequately complete documentation. Simplicity and practical workflow modification in conjunction with increased data utilization in the form of research output were stressed as desirable features that could facilitate the improvement of the current system. Conclusion Data registries enable hospitals and public health systems to engage in primary and secondary interventions, thereby reducing clinical volume loads and increasing clinical efficacy. After engaging in constructive discussion with physicians on the trauma care team at Beni-Suef University Hospital, the goal of workflow modification within existing resources was established as the primary guiding principle for subsequent interventional stages in improving the current trauma registry.