Leadership is the essential human factor in the trauma team – results of a qualitative study

Abstract

Objective: Trauma is the leading cause of death for young people in Norway. Studies indicate that several of these deaths are avoidable if the patient receives correct initial treatment. The trauma team is responsible for initial hospital treatment of traumatized patients, and team members have previously reported that non-technical skills as communication, leadership and cooperation are the major challenges (1). Better team function could improve patient outcome. The aim of this study was to obtain a deeper understanding of which human factors are important to members of the trauma team during initial examination and treatment of trauma patients. Methods: Twelve semi-structured interviews were conducted at four different hospitals of various sizes and with different trauma load. At each hospital a nurse, an anaesthesiologist and a team leader (surgeon) were interviewed. The conversations were transcribed and analyzed using systematic text condensation according to the principles of Giorgi's phenomenological analysis as modified by Malterud. Results: Leadership was perceived as an essential component in trauma management. The ideal leader should be an experienced surgeon, have extensive knowledge of trauma care, communicate clearly and radiate confidence. Team leaders were reported to have little trauma experience, and the team leaders interviewed requested more guidance and supervision. Conclusion: Norwegian trauma-patients will be met by trauma team members that find experienced leaders as one of the key factors to successful trauma treatment. The team might still be led by a junior resident who seeks experience in the team around him. Better qualified and more confident team leaders might enhance the teams' performance. The need for better training of trauma teams and especially team leaders requires further investigation and action.