Assessing the Impact of the Trauma Team Training Program in Tanzania

Bergman, Simon; Deckelbaum, Dan; Lett, Ronald; Haas, Barbara; Demyttenaere, Sebastian; Munthali, Victoria; Mbembati, Naboth; Museru, Lawrence; Razek, Tarek

doi:10.1097/ta.0b013e318184a9fe

Cited by 70 publications

(64 citation statements)

References 9 publications

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“…Trauma resuscitation studies constitute extrapolated evidence (LOE 5) for cardiac arrest patients. One study in Tanzania, 461 2 studies in Trinidad and Tobago 462 and Ecuador, 463 and 1 study in Nigeria 464 reported that implementation of standard ATLS or trauma team training and modified trauma training programs were effective in developing trauma skill competencies in hospital providers. A study from Trinidad and Tobago 465 and 2 studies comparing Cambodia and Northern Iraq 466,467 demonstrated that the delivery of standard or appropriately modified ATLS training to the local community improved hospital mortality from trauma.…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 12: Education, Implementation, and Teams

Mancini¹,

Soar²,

Bhanji³

et al. 2010

Circulation

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Section: Consensus On Sciencementioning

confidence: 99%

Part 12: Education, Implementation, and Teams

Mancini¹,

Soar²,

Bhanji³

et al. 2010

Circulation

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“…Some previous studies in LRS have shown that multidisciplinary team training in simulated trauma and newborn resuscitations improved team performance and resuscitation knowledge and, in some cases, was shown to reduce mortality. [10][11][12][13][14][15] One of these studies found that a low-cost educational intervention can affect knowledge constructs among international teams. 10 Identification and removal of barriers to teamwork and efficiency of decision-making processes become more salient in LRS.…”

Section: What This Study Addsmentioning

confidence: 99%

Identification of Barriers to Pediatric Care in Limited-Resource Settings: A Simulation Study

Shilkofski¹,

Hunt

2015

Pediatrics

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OBJECTIVES: Eighty percent of the 10 million annual deaths in children aged ,5 years in developing countries are estimated to be avoidable, with improvements in education for pediatric emergency management being a key factor. Education must take into account cultural considerations to be effective. Study objectives were: (1) to use simulation to identify factors posing barriers to patient care in limited resource settings (LRS); and (2) to understand how simulations in LRS can affect communication and decision-making processes.METHODS: A qualitative study was conducted at 17 different sites in 12 developing countries in Asia, Latin America, and Africa. Data from observations of 68 in situ simulated pediatric emergencies were coded for thematic analysis. Sixty-two different "key informants" were interviewed regarding perceived benefit of simulations.RESULTS: Coding of observations and interviews yielded common themes: impact of culture on team hierarchy, impact of communication and language barriers on situational awareness, systematic emergency procedures, role delineation, shared cognition and resource awareness through simulation, logistic barriers to patient care, and use of recognition-primed decisionmaking by experienced clinicians. Changes in clinical environments were implemented as a result of simulations.CONCLUSIONS: Ad hoc teams in LRS face challenges in caring safely for patients; these include language and cultural barriers, as well as environmental and resource constraints. Engaging teams in simulations may promote improved communication, identification of systems issues and latent threats to target for remediation. There may be a role for training novices in use of recognition-primed or algorithmic decision-making strategies to improve rapidity and efficiency of decisions in LRS. WHAT'S KNOWN ON THIS SUBJECT:Previous studies in limited resource settings have demonstrated that multidisciplinary team training in simulated trauma and newborn resuscitations improves team performance and resuscitation knowledge and, in some cases, reduces patient mortality regionally in some developing countries. WHAT THIS STUDY ADDS:In situ simulation in limited resource settings identified latent threats to effective pediatric patient care and provided a vehicle to develop shared mental models among multicultural and multidisciplinary teams, despite cultural differences in conceptualization of leadership and emergency decision-making.

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“…Practical simulation can positively affect knowledge and confidence among trauma team members [10,17]. Trauma team organization has been shown to reduce the time to definitive surgery (18) and to reduce mortality [6,15].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Training Program for Surgical Trauma Teams in Botswana

et al. 2014

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Background Trauma represents a challenge to healthcare systems worldwide, particularly in low-and middleincome countries. Positive effects can be achieved by improving trauma care at the scene of the accident and throughout hospitalization and rehabilitation. Therefore, we assessed the long-term effects of national implementation of a training program for multidisciplinary trauma teams in a southern African country. Methods From 2007 to 2009, an educational program for trauma, ''Better and Systematic Team Training,'' (BEST) was implemented at all government hospitals in Botswana. The effects were assessed through interviews, a structured questionnaire, and physical inspections using the World Health Organization's ''Guidelines for Essential Trauma Care.'' Data on human and physical resources, infrastructure, trauma administrative functions, and qualityimprovement activities before and at 2-year follow-up were compared for all 27 government hospitals. Results A majority of hospitals had formed local trauma organizations; half were performing multidisciplinary trauma simulations and some had organized multidisciplinary trauma teams with alarm criteria. A number of hospitals had developed local trauma guidelines and local trauma registries. More equipment for advanced airway management and stiff cervical collars were available after 2 years. There were also improvements in the skills necessary for airway and breathing management. The most changes were seen in the northern region of Botswana. Conclusions Implementation of BEST in Botswana hospitals was associated with several positive changes at 2-year follow-up, particularly for trauma administrative functions and quality-improvement activities. The effects on obtaining technical equipment and skills were moderate and related mostly to airway and breathing management.

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Assessing the Impact of the Trauma Team Training Program in Tanzania

Cited by 70 publications

References 9 publications

Part 12: Education, Implementation, and Teams

Part 12: Education, Implementation, and Teams

Identification of Barriers to Pediatric Care in Limited-Resource Settings: A Simulation Study

Evaluation of Training Program for Surgical Trauma Teams in Botswana

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