Essential TBI Care Survey

ESSENTIAL EQUITABLE TBI CARE: A Delphi Survey to Develop Essential Global Standards for TBI Care

In the management of neurotrauma, evidence for the management of patients is largely derived from data acquired in well-resourced health systems in high-income countries. However, in resource-constrained environments, development of neurotrauma care requires judicious use of limited resources to provide maximal benefit to patients most likely to benefit, often termed ‘fair allocation of scarce resources. Therefore, much of the recommendations which are derived from moderate and low-level evidence and form the backbone of evidence-based guidelines for the management of neurotrauma are neither pragmatic nor cost-effective to practice in resource-constrained environments.

To provide equitable care, improve outcomes of neurotrauma patients, using the fair allocation paradigm and diminishing wasteful medical expenditure. we propose to develop universal standards for clinical processes required to provide essential neurotrauma care to patients globally, defined as the essential care that should be provided to all neurotrauma patients in all hospitals globally.

The “Essential Emergency and Critical Care” (EECC) concept developed by Baker et al, provides a framework of lifesaving, vital organ supporting care processes that should be provided to all critically ill patients in all hospitals worldwide. EECC has been adopted by the government of Tanzania as a spearheading nation and has hubs in Tanzania, Cameroon, Nigeria, Malawi, Rwanda, USA and Sweden. The World Health Assembly in May 2023, adopted a resolution on Integrative Emergency, Critical and Operative Care, which is exemplified in this study’s approach.

Essential TBI care will build on this EECC framework by focusing on essential disease agnostic acute care (EECC), and TBI specific care provided at healthcare facilities with:

1. Only a medical provider (no surgeon or CT imaging): ESSENTIAL CARE
2. A surgeon and CT scan is available (but no neurosurgeon): INTERMEDIATE CARE
3. A neurosurgeon, surgeon and a CT scanner is available: ADVANCED CARE

Attached is a link to the Delphi which is divided into EECC care and the 3 levels of TBI care. Kindly select the responses most compatible with your practice and referral patterns. The aim is to define levels of care and their elements that are aspirational in being pragmatic, consistent and equitable.

SURVEY LINK https://www.smartsurvey.co.uk/s/FXV8U0/
PLEASE DO NOT PARTICIPATE AGAIN IF YOU PREVIOUSLY RESPONDED TO THE SURVEY