Prehospital Trauma Quality Improvement: The Role of Prehospital Database in Improving Timely Access to Trauma Care.
World Journal of Surgery · 2025-07-08 · Implementation & quality improvement
Abstract
BACKGROUND: Prehospital travel time is critical in trauma patients, with delays and undertriage linked to worse outcomes. We hypothesize that implementing a regional prehospital database will reveal trauma distribution patterns and the underlying causes of delays and undertriage. METHODS: We analyzed 102,895 incident reports from 50 prehospital dispatch centers in Riyadh, using data from the Saudi Red Crescent Authority between January 2021 and March 2023. Distribution of dispatch centers as well as trauma and nontrauma centers (NTC) was mapped using QGIS. Network service zone analysis was applied to delineate service areas for trauma centers (TC), based on road networks and speed limits. Dispatch centers were subsequently grouped according to these service zones to evaluate delays (travel times > 60 min to a level 1 or 2 TC) and undertriage to NTC. RESULTS: The entire city of Riyadh has access to level 1 and 2 TC within 60 min. The East (41.5%) and North (24.9%) regions have the highest trauma burden, with blunt trauma being the most common injury type (68.3%), followed by penetrating trauma (21.1%). Among red criteria cases, 66.8% were transferred to level 1 or 2 TC, with 21.1% experiencing delays (ranging from 9.7% to 57.7% across dispatch centers) and 28.7% (ranging from 7.0% to 64.8% across dispatch centers) undertriaged to nontrauma centers. The highest delays were observed in the 60 min service area (North). CONCLUSION: Despite access to TC, delays and undertriage of trauma patients are common, especially in areas with longer travel times. Implementation of prehospital databases can help identify areas with high burden of trauma that are prone to delays and undertriage, thereby improving the timeliness and accuracy of trauma triage.
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Tags
Implementation · Time intervals
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