715 Improving initial management of the injured at Ghanaian district and regional hospitals with a trauma intake form: implementation outcomes

<h3>Background</h3> Globally, injuries are a leading cause of death, especially in low- and middle-income countries. Although trauma care improvements have reduced mortality rates, efforts in these countries mainly target tertiary centers rather than smaller hospitals closer to the scene of injuries. Enhancing initial assessment and care provision at the primary access point to the health system could significantly enhance outcomes for those injured in resource-constrained, conflict-affected, or fragile settings. In this study, a standardized trauma intake form (TIF) with real-time clinical decision support prompts was developed for non-specialized providers in eight non-tertiary hospitals in Ghana. The TIF led to a notable decrease in mortality rate from 17.7% to 12.1% among seriously injured patients and improved 14 of 16 trauma care key performance indicators for all patients seeking care. <h3>Methods</h3> Understanding the implementation of this intervention is crucial for scaling it up in Ghana and beyond. In this study, we conducted a mixed-methods evaluation with 241 clinicians. <h3>Results</h3> Uptake of the TIF varied among facilities, with some showing high adoption rates while others lagged behind. Despite generally positive perceptions of the TIF’s acceptability and feasibility, concerns about time constraints were noted. Suggestions for improvement included making the form shorter, more user-friendly, and tailored to different clinician types. <h3>Conclusions</h3> Overall, the study demonstrates the effectiveness of the TIF in improving clinical outcomes and its perceived acceptability. However, addressing issues such as limited uptake in some facilities requires tailoring the form to suit the needs of smaller, low-volume facilities. Lessons learned from this study are relevant for improving trauma care provision in similar resource-constrained and fragile settings.