Assessing Emergency Clinicians' Needs From Trauma Clinical Guidance: A Mixed-Methods Study.

BACKGROUND: In the United States, emergency clinicians are often the first to care for injured patients in the hospital setting. Current trauma clinical guidance does not consistently meet the needs of emergency clinicians caring for this population. OBJECTIVES: To better understand end-user needs, we evaluated emergency clinician priorities and preferences in accessing, interpreting, and applying trauma clinical guidance. METHODS: Emergency clinicians were recruited via email for semi-structured video conference interviews. Rapid directed qualitative analysis of interview notes and audio recordings yielded initial insights about guidance barriers and facilitators. A subsequent quantitative survey was developed and distributed via email to members of relevant professional associations. Survey results were analyzed using descriptive and inferential statistics. RESULTS: Twelve emergency clinicians participated in interviews. A total of 154 eligible participants responded to the survey. Clinicians expressed support for trauma clinical guidance overall but often find resources lacking. Barriers to guidance usage include lack of awareness, difficulty locating guidance, and cumbersome design. Clinical guidance should be objective, concise, updated, and easy-to-use at bedside. The strongest determinant of guidance usability was being quickly understood in a time-pressured situation. Clinicians prefer to access guidance through mobile applications or multi-modal channels. Rural clinicians reported additional difficulties in staffing and having resources needed to follow guidance. CONCLUSION: When developing trauma clinical guidance, the trauma community should continue to consider the variety of end users and clinical settings, including emergency clinicians. Mobile device-friendly and quickly understandable formats may be important considerations for authors of trauma clinical guidance, although further work with larger and more diverse population is needed.