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Abstract

Background: Interfacility transport (IFT) of trauma patients in British Columbia (BC) is hindered by fragmented systems of data-sharing and communication. These challenges can contribute to increased patient morbidity and mortality, poor resource allocation, and increased healthcare costs. Objective: This thesis examines the challenges to data-sharing and communication affecting IFT in BC using a systems-based approach. We also evaluate T6 - a digital platform designed for trauma care - and its potential to support these challenges through a proof-of-concept pilot study. Methods: 1) A process map (PM) of IFT of trauma patients in BC was developed and validated with subject matter experts (SMEs) from involved organizations. The PM was used to facilitate semi-structured interviews focused on identifying key communication and data-sharing issues. Thematic analysis was conducted to extract major challenges. 2) The identified challenges were translated into user requirements. Using these and the PM, we evaluated T6 as a potential tool to support improved data-sharing and communication. We then conducted a single-center, observational, prospective cohort study to assess the feasibility and completeness when using T6 to document and collect data during trauma activations at Vancouver General Hospital. Results: 1) Seventeen interviews were conducted, with representation for all major organizations. The PM was validated as accurate. Thematic analysis revealed eight key challenges: the transport call process, redundant communication systems, lack of resource situational awareness, out-of-hospital to hospital communication, limited transport resources, interoperability, lack of data for performance analysis, and repatriation delays. 2) Pilot testing of T6 demonstrated that it was feasible to use at our centre and achieved comparable data capture to existing paper record. Conclusion: IFT of trauma patients in BC relies on coordination across multiple organizations. We successfully developed and validated a PM that brings transparency to this complex system and supports a whole-system approach to process improvement. This process identified critical challenges in communication and data-sharing. Early testing of T6 suggests it may address several of these gaps, supporting its potential as an innovative tool in trauma care.