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

Abstract

Introduction. Kansas has a regionalized trauma system
with formal mechanisms for review, however, increased
communication with rural providers can uncover opportunities
for system process improvement. Therefore, this
qualitative study explored perceptions of family medicine
physicians staffing emergency departments (ED) in rural areas,
specifically to determine what is going well and what areas
needed improvement in relation to the trauma system.

Methods. A focus group included Kansas rural family physicians
recruited from a local symposium for family medicine
physicians. Demographic information was collected via survey
prior to the focus group session, which was audiotaped.
Research team members read the transcription, identified
themes, and grouped the findings into categories for analysis.

Results. Seven rural family medicine physicians participated in
the focus group. The majority were male (71%) with the mean age
46.71 years. All saw patients in the ED and had treated injuries
due to agriculture, falls, and motor vehicle collisions. Participants
identified successes in the adoption and enforcement of standardized
processes, specifically through level IV trauma center
certification and staff requirements for Advanced Trauma Life
Support training. Communication breakdown during patient discharge
and skill maintenance were the most prevalent challenges.

Conclusions. Even with an established regionalized trauma
system in the state of Kansas, there continues to be opportunities
for improvement. The challenges acknowledged by
focus group participants may not be identified through patient
case reviews (if conducted), therefore tertiary centers
should conduct system reviews with referring hospitals regularly
to improve systemic concerns. KS J Med 2017;10(1):12-16.