Development of a novel Global Trauma System Evaluation Tool and initial results of implementation in the Republic of South Sudan

Kyle N. Remick*, Evan G. Wong, Chep Chuot Chep, Richard T. Morton, Abdullah Monsour, Dane Fisher, John S. Oh, Ramey Wilson, Debra L. Malone, Charles Branas, Eric Elster, Kirby R. Gross, Adam L. Kushner

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Introduction: Trauma remains a leading cause of death and disability in the world, and trauma systems decrease mortality from trauma. We developed the Global Trauma System Evaluation Tool (G-TSET) specifically for use in low- and middle-income countries (LMICs). The Sudan Peoples Liberation Army (SPLA) in the Republic of South Sudan (RSS) desires a military trauma system (MTS) which allowed us to pilot the G-TSET.

Methods: The G-TSET was developed by modifying key components of a trauma system applicable to LMICs. We partnered with the SPLA Medical Corps using clinical collaboration, direct observation, and discussion groups. Benchmarks and indicators were scored with 5 indicating full capability and 1 meaning not present and were used to develop a SPLA MTS plan.

Results: The overall MTS score was 1.15 indicating an urgent need for system development. The assessment highlighted the need for SPLA Command support. Battlefield care, transport to a trauma facility, and inter-facility communication were identified for improvement. After essential battlefield care, consisting primarily of bandaging and splinting, transport times for injured SPLA soldiers were 12 h to 3 days by truck. Based on our findings, we collaborated with SPLA medical leadership to develop a plan to develop a formal MTS.

Conclusion: We piloted a novel trauma system assessment tool for the MTS in the RSS. Qualitatively, we identified gaps in the MTS and provided the medical leadership with a plan for improvement. We anticipate a short-term follow-up to quantify improvement, and we seek to validate this tool for use in other countries.

Original languageEnglish
Pages (from-to)1731-1735
Number of pages5
Issue number11
StatePublished - 1 Nov 2014
Externally publishedYes


  • Global injury
  • Global surgery
  • Injury care
  • International surgery
  • Trauma systems


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