Successes and Challenges of Optimal Trauma Care for Rural Family Physicians in Kansas

Abstract

Introduction. Kansas has a regionalized trauma systemwith formal mechanisms for review, however, increasedcommunication with rural providers can uncover opportunitiesfor system process improvement. Therefore, thisqualitative study explored perceptions of family medicinephysicians staffing emergency departments (ED) in rural areas,specifically to determine what is going well and what areasneeded improvement in relation to the trauma system. Methods. A focus group included Kansas rural family physiciansrecruited from a local symposium for family medicinephysicians. Demographic information was collected via surveyprior to the focus group session, which was audiotaped.Research team members read the transcription, identifiedthemes, and grouped the findings into categories for analysis. Results. Seven rural family medicine physicians participated inthe focus group. The majority were male (71%) with the mean age46.71 years. All saw patients in the ED and had treated injuriesdue to agriculture, falls, and motor vehicle collisions. Participantsidentified successes in the adoption and enforcement of standardizedprocesses, specifically through level IV trauma centercertification and staff requirements for Advanced Trauma LifeSupport training. Communication breakdown during patient dischargeand skill maintenance were the most prevalent challenges. Conclusions. Even with an established regionalized traumasystem in the state of Kansas, there continues to be opportunitiesfor improvement. The challenges acknowledged byfocus group participants may not be identified through patientcase reviews (if conducted), therefore tertiary centersshould conduct system reviews with referring hospitals regularlyto improve systemic concerns. KS J Med 2017;10(1):12-16.