In the US, trauma is the leading cause of mortality for people under the age of 45. Organized trauma systems save lives and improve outcomes after injury. However, no validated, widely accepted method has been established to optimize the location of trauma centers.

ISE associate professor Shan Liu, along with a team of researchers from across the UW, has received a UW Population Health initiative grant to research improving access to trauma care in Washington state. The project will use a mathematical modeling approach that accounts for the complex interaction between multiple inputs to the state trauma system to determine where trauma centers should be located.

We talked with Liu about the project.

How did the collaboration between you and the other researchers come about?

I had a few past collaborations with faculty in the department of global health, and one of them recommended me to the lead investigator on this grant, Dr. Rebecca Maine, from the department of surgery. Dr. Maine was looking for industrial engineering experts to help out with work related to facility location and resource allocation in trauma center planning. We had a few meetings to discuss the topics and existing literature. We found there are many important questions to explore in the trauma systems using systems modeling and optimization methods. We then formed a strong team including faculty from the departments of global health, epidemiology, and anesthesia across the UW to tackle this challenging problem.

What led you to become interested in improving access to trauma care?

My research focuses on the design and evaluation of healthcare interventions to improve patients’ health and enable cost-effective care delivery. There are many interesting methodological challenges to overcome in solving the optimal allocation of trauma centers using optimization and systems modeling. It is an exciting problem to work on with significant potential societal benefits to our state.

What are the primary challenges in delivering trauma care?

A well-functioning, organized trauma system is the result of a complex interplay of multiple factors, including pre-hospital care, triage to appropriately resourced trauma centers, timeliness and quality of care in trauma centers, and access to post-discharge services. Guidance exists from national and international organizations for trauma system development; however, there is controversy regarding how to determine how many trauma centers are needed for a given region and what the appropriate geographic distribution of centers should be. The optimal trauma system should strive for a balance between access to care to limit preventable deaths while avoiding duplication of resources in a geographic region. The goal of this project is to leverage the expertise of ISE to develop a comprehensive system modeling approach to inform policy makers of the optimal distribution of trauma centers in an inclusive, statewide trauma system.

How long will this project last?

The UW Population Health Initiative Pilot Grant is a one-year project. After completion of this project, we will continue working on this topic and applying and adapting what we learned here to other low-resource settings.