The challenges and opportunities of major trauma care in Germany – results of multidisciplinary expert interviews of the LeAf trauma study

BACKGROUND: The recovery process of major trauma survivors involves various sectors within a complex system of different medical service providers and stakeholders who accompany and support patients throughout the recovery pathway. The aim was to explore experiences and opinions of experts, who are actively involved in the care of major trauma patients in the German healthcare system. METHODS: Semistructured in-depth group interviews were used to investigate experiences and opinions of experts with the focus on exploration of expert perspectives on opportunities and challenges of the cross sectoral care. An exploratory analysis was performed with an artificial intelligence-based coding software. In a second step, a system map was developed, and all inter- and intra-sectoral challenges and all opportunities for the optimization of processes were mapped. RESULTS: 39 experts from 13 medical specialties and occupational groups who were interviewed highlighted that intersectional issues especially across and within sectors pose a significant challenge to patient care. Four challenges were highlighted that significantly influence patient care: (1) Communication between sectors; (2) Complexity of transitions between sectors; (3) Inadequate aftercare and (4) Lack of psychosocial care. DISCUSSION: In conclusion five key learnings can be derived which could help to transform the healthcare system towards a system in which the complex condition major trauma with its high potential of chronification is enabling patients towards living a self-determined life and is creating opportunities for patients to return to work: (1) interdisciplinary collaboration (2), improved communication (3), early psychosocial screening and intervention (4), continuity of care (5), involvement of relatives.