Barclay T Stewart1,2, Kajal Mehta3, Monique Drago4, Sharon Henry4,5, Kimberly Joseph4,6, Kathryn Strong4, Julio L Trostchansky4,7, Jorgen Joakim Jorgensen4,8, Gilberto Ka-Kit Leung4,9, George S Abi-Saad4,10, Eileen Bulger3,11,4, Charles Mock3,11. 1. Department of Surgery, University of Washington, Seattle, USA. barclays@uw.edu. 2. Harborview Injury Prevention and Research Center, Seattle, USA. barclays@uw.edu. 3. Department of Surgery, University of Washington, Seattle, USA. 4. American College of Surgeons (ACS) Committee on Trauma (COT), Chicago, USA. 5. Department of Surgery, University of Maryland, College Park, USA. 6. Department of Trauma and Burns, John H. Stroger Hospital of Cook County, Chicago, USA. 7. Sociedad de Cirugía del Uruguay, Montevideo, Uruguay. 8. Department of Traumatology, Oslo University Hospital, Oslo, Norway. 9. Clinical Neuroscience, Hong Kong University, Pok Fu Lam, Hong Kong. 10. Department of Surgery, American University of Beirut, Beirut, Lebanon. 11. Harborview Injury Prevention and Research Center, Seattle, USA.
Abstract
BACKGROUND: We aimed to identify and describe demand-side factors that have been used to support ATLS global promulgation, as well as current gaps in demand-side incentives. METHODS: We performed a cross-sectional survey about demand-side factors that influence the uptake and promulgation of ATLS and other trauma-related CME courses. The survey was sent to each of the four global ATLS region chiefs and 80 ATLS country directors. Responses were described and qualitative data were analyzed using a content analysis framework. RESULTS: Representatives from 30 countries and each region chief responded to the survey (40% response rate). Twenty of 30 country directors (66%) reported that there were some form of ATLS verification requirements. ATLS completion, not current verification, was often the benchmark. Individual healthcare systems were the most common agency to require ATLS verification (37% of countries) followed by medical/surgical accreditation boards (33%), governments (23%), training programs (27%), and professional societies (17%). Multiple credentialing frameworks were reported including making ATLS verification a requirement for: emergency unit or trauma center designation (40%), contract renewal or promotion (37%); professional licensing (37%); training program graduation (37%); and increases in remuneration (3%). Unique demand-side incentives were reported including expansion of ATLS to non-physician cadre credentialing and use of subsidies. CONCLUSION: ATLS region chiefs and country directors reported a variety of demand-side incentives that may facilitate the promulgation of ATLS. Actionable steps include: (i) shift incentivization from ATLS course completion to maintenance of verification; (ii) develop an incentive toolkit of best practices to support implementation; and (iii) engage leadership stakeholders to use demand-side incentives to improve the training and capabilities of the providers they oversee to care for the injured.
BACKGROUND: We aimed to identify and describe demand-side factors that have been used to support ATLS global promulgation, as well as current gaps in demand-side incentives. METHODS: We performed a cross-sectional survey about demand-side factors that influence the uptake and promulgation of ATLS and other trauma-related CME courses. The survey was sent to each of the four global ATLS region chiefs and 80 ATLS country directors. Responses were described and qualitative data were analyzed using a content analysis framework. RESULTS: Representatives from 30 countries and each region chief responded to the survey (40% response rate). Twenty of 30 country directors (66%) reported that there were some form of ATLS verification requirements. ATLS completion, not current verification, was often the benchmark. Individual healthcare systems were the most common agency to require ATLS verification (37% of countries) followed by medical/surgical accreditation boards (33%), governments (23%), training programs (27%), and professional societies (17%). Multiple credentialing frameworks were reported including making ATLS verification a requirement for: emergency unit or trauma center designation (40%), contract renewal or promotion (37%); professional licensing (37%); training program graduation (37%); and increases in remuneration (3%). Unique demand-side incentives were reported including expansion of ATLS to non-physician cadre credentialing and use of subsidies. CONCLUSION: ATLS region chiefs and country directors reported a variety of demand-side incentives that may facilitate the promulgation of ATLS. Actionable steps include: (i) shift incentivization from ATLS course completion to maintenance of verification; (ii) develop an incentive toolkit of best practices to support implementation; and (iii) engage leadership stakeholders to use demand-side incentives to improve the training and capabilities of the providers they oversee to care for the injured.
Authors: Marisa Nádas; Rachel Bedenbaugh; Michelle Morse; Graham T McMahon; Christine L Curry Journal: Ann Glob Health Date: 2015 Mar-Apr Impact factor: 2.462
Authors: Charles Mock; Son Nguyen; Robert Quansah; Carlos Arreola-Risa; Ramesh Viradia; Manjul Joshipura Journal: World J Surg Date: 2006-06 Impact factor: 3.352