Exploring the provision of hospital trauma care for road traffic injury victims in Iran: a qualitative approach

BACKGROUND Identifying factors affecting the provision of trauma care is essential for improving the quality of care for road traffic injury (RTI) victims. The study aimed to explore the perceptions and experiences of trauma care among injured patients and health professionals to identify factors influencing an effective trauma care delivery at emergency departments (EDs) in Iran. METHODS The study was conducted with a grounded theory approach. The study participants consisted of 15 health professionals and 20 injured patients. The data were collected via semi-structured interviews and were analyzed using constant comparative analysis method. RESULTS Lack of a systematic approach to providing trauma care at EDs emerged as the core category. The leading factors in the development of the core category were unclear national policies and poor organization of care at the ED. Other major factors were contextual factors in the environment of the hospitals such as inappropriate structure and unsupportive environment and also factors specific to the context of Iran such as a rapid increase in the number of traumas. Professionals reacted to the prevailing conditions in ways that contributed to an ineffective trauma care, even though strategies employed by Emergency Medicine Physicians (EMPs) improved the quality of trauma care locally. CONCLUSIONS Building a national trauma system, using available professional resources especially EMPs, and implementing low cost and evidence-based improvements such as establishing trauma teams and trauma training for staff working at the EDs on a regular basis is necessary in order to improve delivery of trauma care at the hospitals.