Strategic Decision-Making in Trauma Systems

Trauma care and trauma systems are vital community assets. A trauma system manages the treatment of severely injured people and spans the full spectrum of prevention and emergency care to recovery and rehabilitation. While most trauma-related studies concern the operational and tactical levels of trauma care and trauma systems, little attention has been given to a strategic level (top-down) approach to a trauma system from a financial and investment perspective. In this paper, we analyze a statewide trauma system and model it as a network of trauma centers, hospitals and emergency medical services (EMS). We develop a theoretical model and a general-purpose computational framework that facilitates the allocation and utilization of resources by the statewide trauma system. Given a local trauma network profile, injury distribution and resource requests, the modeling and computational framework enable the creation of the set of all feasible and Pareto-efficient portfolios where limited funding is allocated across numerous resource requests from trauma centers, hospitals and EMS providers. Using the computational framework, decision-makers can quantitatively analyze the impact of each feasible portfolio on the trauma system’s performance measures via the Trauma System Simulator. Sensitivity analysis can be conducted to determine the best decision or policy for transporting and transferring patients and to observe how changes in system inputs affect the return on investment (ROI) and resource utilization. Using the trauma system data in Georgia, our findings confirm that such dynamic and strategic resource-allocation analyses empower decision-makers to make informed decisions that benefit the entire trauma network. The design is a top-down approach at a strategic level that simultaneously uses tactical-level decisions to evaluate several strategies to improve the trauma system.