Evaluation of training program for surgical trauma teams in botswana
Presentations from the 9th Annual Electric Utilities Environmental Conference
Unit for International Collaboration, Haukeland University Hospital, Bergen, Norway; Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway; Department of Surgery, Nyangabgwe Referral Hospital, Francistown, Botswana; Department of Acute and Gastrointestinal Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, K1, University of Bergen, Bergen, Norway; BEST Foundation: Better and Systematic Team Training, Department of Acute Care, Hammerfest Hospital, Hammerfest, Norway; Anaesthesia and Critical Care Research Group, Faculty of Health Sciences, University of Tromso, Tromso, Norway; Norwegian Trauma Competency Service, Oslo University Hospital, Oslo, Norway; Norwegian Medical Association, Oslo, Norway
Background: Trauma represents a challenge to healthcare systems worldwide, particularly in low-and middle-income 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 quality-improvement 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. © 2014 Société Internationale de Chirurgie.
Botswana; developing country; devices; education; evaluation study; human; organization and management; patient care; practice guideline; program evaluation; public hospital; register; respiration control; standards; time; total quality management; traumatology; Wounds and Injuries; Airway Management; Botswana; Developing Countries; Hospitals, District; Humans; Patient Care Team; Practice Guidelines as Topic; Program Evaluation; Quality Improvement; Registries; Time Factors; Traumatology; Wounds and Injuries
Laerdal Foundation for Acute Medicine