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0162 Development of a field assessment conditioning tool (FACT) – an exploration of the role of healthcare advocacy
  1. Ralph MacKinnon1,2,
  2. Chris Kennedy3,
  3. Rachael Fleming1,
  4. Terese Stenfors-Hayes2
  1. 1Royal Manchester Children’s Hospital, Manchester, UK
  2. 2Karolinska Institute, Stockholm, Sweden
  3. 3Children’s Mercy Hospital, Kansas City, Kansas City, USA


Background We have designed an assessment instrument, to empower health care advocacy by trauma team members and managers.1 The context of the assessment is the readiness of hospitals to receive traumatically injured children, as trauma is the leading cause of mortality in infants and children.2 The instrument is to be used by the healthcare professionals that constitute or manage trauma teams, and highlights a series of trauma team hospital interactions and performances. The instrument enables the description, reflection, evaluation and eventual improvement of team – hospital interactions by health advocacy.

Methodology We have run unannounced fully immersive in-situ/point of care paediatric trauma simulations in a major paediatric trauma centre, once a month, for over 24 months, to date. We tested the instrument (Field Assessment Conditioning Tool (FACT)) utilising high fidelity patient simulators as surrogates for real children presenting to trauma bays. These were followed by semi-structured interviews with both trauma team members and trauma governance board administrators.

Results Four themes emerged from interviews:

  1. The support for a more holistic approach to evaluating and assessing both the organisation’s and trauma team’s readiness to receive paediatric trauma.

  2. The support for harnessing internal expertise of all team members to evaluate quality of trauma care.

  3. The FACT provides a language to describe, evaluate quality and potentially invoke changes.

  4. Perceived usefulness by all of the staff (team members and governance boards) will determine to a large extent to which the FACT will be used.

Potential impact Assessing all aspects of medical performance is complex and requires a programme of assessment incorporating both psychometric measurements instruments and framework tools. This is especially important to support the role of health advocates.

Preliminary data from the FACT implementation and evaluation contributes to the conceptual validity of this approach to assessment.


  1. MacKinnon RJ, Kennedy C, Doherty C, Shepherd M, Cole J, Stenfors-Hayes T, on behalf of the INSPIRE Trauma Outreach. Fitness for purpose study of the Field Assessment Conditioning Tool (FACT): a research protocol. Med Educ Train BMJ Open 2015;5:e006386 doi:10.1136/bmjopen-2014-006386

  2. Centers for Disease Control and Prevention. National Center for Health Statistics. VitalStats. [accessed April 20, 2013]

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