Measuring preparedness of hospitals to manage traumatic brain injuries: Criterion development and assessment in an Indian district

The objectives of the study are to develop a criterion to objectively assess the preparedness of hospitals to manage traumatic brain injuries (TBIs) and to assess and classify the preparedness of secondary and tertiary care hospitals to manage TBIs in an Indian district. This ethically approved hospital-based cross-sectional study was conducted between June 2022 and February 2023 in all eligible secondary and tertiary hospitals in Kolar, Karnataka, India. A study instrument (Form 1, 2, and 3) and the criterion (level-numeric scoring system) to objectively measure the preparedness of hospitals to manage TBIs were developed based on the Neurotrauma Society of India guidelines. This was used to collect data on facilities, manpower, intensive care unit care, drugs, and equipment available for managing TBI in hospitals, by a combination of observation, interview, and verification of records. Based on the assessment, the preparedness of each hospital was categorized into different levels and scores. We assessed all 11 eligible hospitals in the district of which 81% are categorized as having Level 4 preparedness to manage TBIs (corresponds to the management of mild head injury cases). One hospital each had Level 2 and Level 3 preparedness to manage TBIs (moderate and severe). There was no Level 1 preparedness in hospital in the district. Most hospitals were identified to have Level 4 preparedness, indicating a need for comprehensive strengthening of secondary and tertiary hospitals to manage TBI cases in the district.