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Health services research
Research
Providing effective trauma care: the potential for service provider views to enhance the quality of care (qualitative study nested within a multicentre longitudinal quantitative study)
  1. Kate Beckett1,
  2. Sarah Earthy2,
  3. Jude Sleney2,
  4. Jo Barnes3,
  5. Blerina Kellezi4,
  6. Marcus Barker5,
  7. Julie Clarkson6,
  8. Frank Coffey7,
  9. Georgina Elder8,
  10. Denise Kendrick9,
  11. The Impact of Injuries Study group
  1. 1University of the West of England, Research and Innovation, University Hospitals Bristol NHS Foundation Trust, Education Centre, Bristol, UK
  2. 2Department of Sociology, Faculty of Arts and Human Sciences, University of Surrey, Guildford, Surrey, UK
  3. 3Loughborough Design School, Loughborough, UK
  4. 4Division of Primary Care, School of Medicine, Nottingham University, University Park, Nottingham, UK
  5. 5Nottingham University Business School, Nottingham, UK
  6. 6Nottingham University Hospitals, Nottingham, UK
  7. 7DREEAM (Department of Research and Education in Emergency medicine, Acute Medicine and Major Trauma), Nottingham University Hospitals NHS Trust, Nottingham, UK
  8. 8Department of Emergency, Bristol Royal Infirmary, Bristol, UK
  9. 9Division of Primary Care, School of Medicine, University Park, Nottingham, UK
  1. Correspondence to Professor Denise Kendrick; Denise.Kendrick{at}Nottingham.ac.uk

Abstract

Objective To explore views of service providers caring for injured people on: the extent to which services meet patients’ needs and their perspectives on factors contributing to any identified gaps in service provision.

Design Qualitative study nested within a quantitative multicentre longitudinal study assessing longer term impact of unintentional injuries in working age adults. Sampling frame for service providers was based on patient-reported service use in the quantitative study, patient interviews and advice of previously injured lay research advisers. Service providers’ views were elicited through semistructured interviews. Data were analysed using thematic analysis.

Setting Participants were recruited from a range of settings and services in acute hospital trusts in four study centres (Bristol, Leicester, Nottingham and Surrey) and surrounding areas.

Participants 40 service providers from a range of disciplines.

Results Service providers described two distinct models of trauma care: an ‘ideal’ model, informed by professional knowledge of the impact of injury and awareness of best models of care, and a ‘real’ model based on the realities of National Health Service (NHS) practice. Participants’ ‘ideal’ model was consistent with standards of high-quality effective trauma care and while there were examples of services meeting the ideal model, ‘real’ care could also be fragmented and inequitable with major gaps in provision. Service provider accounts provide evidence of comprehensive understanding of patients’ needs, awareness of best practice, compassion and research but reveal significant organisational and resource barriers limiting implementation of knowledge in practice.

Conclusions Service providers envisage an ‘ideal’ model of trauma care which is timely, equitable, effective and holistic, but this can differ from the care currently provided. Their experiences provide many suggestions for service improvements to bridge the gap between ‘real’ and ‘ideal’ care. Using service provider views to inform service design and delivery could enhance the quality, patient experience and outcomes of care.

  • Qualitative Research
  • Accident & Emergency Medicine
  • Trauma Management

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2014-005668

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