Abstract

BackgroundMajor trauma patients—such as patients who have experienced road injury, high-impact falls or violence—require complex, intense and rapid resuscitation from a multidisciplinary team of clinicians. These ‘flash teams’ must form quickly and function effectively, often having never met before. There is evidence that multidisciplinary teamwork training improves the performance of the trauma team in simulation. However, the translation of learnt resuscitation teamwork skills from simulation into clinical practice has had modest and variable effects. This paper outlines a method for developing an intervention designed to translate the teaching from a simulated training environment into clinical practice using the theoretical domains framework, behaviour change wheel and behaviour change techniques as the theoretical and empirical basis for the process.MethodsThe data used to inform the intervention development process were collected during an implementation evaluation study of the trauma team training programme at the busiest level 1 trauma centre in Sydney, Australia. A detailed barrier and enabler assessment were conducted using qualitative and quantitative data. The theoretical domains framework was used to integrate the results. Implementation interventions were selected using the behaviour change wheel.ResultsTwenty-three facilitators and 19 barriers were identified to influence the implementation of trauma team training in the clinical setting. The facilitators and barriers corresponded to all 14 domains of the theoretical domains framework. Seven intervention functions and four policy categories of the behavioural change wheel were selected to address the target behaviours, and a multimodal relaunch of the revised trauma team training programme was developed.ConclusionsThis study offers a framework for deductively employing the theoretical domains framework, behaviour change wheel and behaviour change techniques to assess and develop intervention strategies to improve the functioning of trauma resuscitation teams.

Highlights

  • Major trauma patients—such as patients who have experienced road injury, high-impact falls or violence—require complex, intense and rapid resuscitation from a multidisciplinary team of clinicians

  • Impact of trauma team training (TTT) on patient outcomes and health service delivery There were no differences between the groups with respect to gender, body region injured, incidence of polytrauma and pattern of arrival to Emergency Department (ED)

  • Innovative educational strategies The current TTT programme needs refinement to ensure that it is fit for purpose, i.e. training participants to work in spontaneously created trauma teams with constantly changing membership

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Summary

Methods

The data used to inform the intervention development process were collected during an implementation evaluation study of the trauma team training programme at the busiest level 1 trauma centre in Sydney, Australia. A detailed barrier and enabler assessment were conducted using qualitative and quantitative data. The theoretical domains framework was used to integrate the results. Implementation interventions were selected using the behaviour change wheel

Results
Conclusions
Background
Motivation and goals
Regulations
Revision of equipment organisation and ergonomics
Discussion
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Limitations and strengths
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