Problem identification methods and frameworks

Trauma centers, whether they are stand-alone facilities or a part of a hospital or other healthcare facility, play key roles in ensuring that people get proper healthcare when there is a man-made or natural disaster (Premier, 2012. Because trauma centers are so vital, they have to become well-established in the community (Trunkey & Potter, 2006). That can allow them to be prepared for almost anything, and they can work with the community once a disaster has occurred. This reduces the number of casualties from a disaster as much as possible, but no trauma center will be perfect or will be prepared to handle any eventuality. There is always room for improvement. Studies have shown that many of the trauma centers throughout the country are really not adequately prepared for a major disaster (Premier, 2012). That lack of preparedness will cost lives, but the funding is not available for new and better equipment at the trauma centers. Additionally, these centers are often short on staff because the pay can be low and the hours are long (Trunkey & Potter, 2006).

Despite the uphill battle that will need to be fought, it is clear that trauma centers must be improved in order to save the largest number of lives during and after a major disaster. Trauma centers must improve their readiness, and emergency management in general must improve its effectiveness. Neither of these will be easy tasks, but they are vital to the protection of citizens when a natural or man-made disaster occurs. While unrealistic to assume there will be no loss of life, there are many ways to make trauma centers and emergency management more effective so that fewer people perish when something goes wrong or Mother Nature decides to bring the U.S. something like Katrina again. Planning for that particular storm was poor, and it resulted in many deaths that could have been avoided. Changes to emergency management and trauma centers can keep that from taking place again.

The conceptual framework for this study will be operations research. Operations research is a sub-field of mathematics, and is sometimes called decision science (Hillier & Lieberman, 2005; Pidd, 2003). It allows the researcher to apply advanced analytical methods to a problem (Pidd, 2003). The theory is that using this method will allow the researcher to make better decisions about what should be done in a particular scenario. That can allow the researcher of the current study to show the expected outcomes of various changes to emergency management and trauma facilities. By addressing the research this way, scenarios can be addressed, and either accepted or rejected. It is a way of making scientific predictions, and can help the researcher determine the best possible outcome depending on what is done in order to make changes in the area of study.

Operations research creates a strong foundation for this study because it is focused on the different options that can be addressed (Hillier & Lieberman, 2005). That is exactly what emergency management needs - to look at the options that are available and realistic, and to choose the option that will be the best one for the future. It is not always easy to determine which option is best, but once several are presented and can be analyzed, making a choice becomes much more likely. Additionally, it is more likely that the right choice (or at least an acceptable choice) will be made. That is a very important distinction to consider. Anyone can make a choice, but without all the evidence it is possible that the choice will be one that will be regrettable in the future. Using operations research is one of the best ways to focus on the various choices that are available in a scientific, analytical, and prescribed manner (Hillier & Lieberman, 2005; Pidd, 2003). By doing that, emergency management and trauma centers will be able to make changes that save more lives. Since that is what they are in business to do, the can only see improvement.

The research does not generate a new theory, but it does expand on the current theory and work to improve and confirm that theory. In other words, the theory that there are improvements needed to emergency management and trauma centers, and that making these improvements would save more lives is not a new theory. It is only common sense that better trauma centers would mean fewer deaths. Additionally, the better and faster the response from emergency management the more likely a person (or large group of people) would be to survive either a man-made or natural disaster. While that would be an expected outcome, one still has to consider the ways in which improvements need to be made - and in what ways can those improvements be made. There are some thing that would help but are just not feasible. There is only funding and staffing for a certain number of facilities and a certain number of emergency management personnel.

By researching this issue, a theory can be refined and added to. For example, even when everyone is in agreement that more personnel and better response times would save lives, there are still issues that have to be worked out and defined. How will the facility pay for more people? Where will the facility put more patients when it is already near capacity? How can the emergency management team be ready for a disaster and be able to get to the disaster-stricken area faster, while still staying out of harm's way during the disaster. The response teams and the staff at the trauma centers cannot do anyone any good if they, too, are injured in the disaster. Some disasters are unexpected, but for those that are expected (such as hurricanes) there must be better ways to get help to the public in the aftermath of the storm without putting the emergency management workers at increased risk.

The research tests to confirm a theory, not to refute it. There is no theory that says it would be a bad idea to have better emergency management and trauma facilities, and that doing those things would cost lives. There is nothing to refute. Instead, the theory is that better emergency management response and better trauma centers would save more lives. By using operations research and considering possible scenarios, that theory can be tested and potentially confirmed. There may also be several sub-theories with which to contend, because there are undoubtedly different ways of improving trauma centers and increasing the response of emergency management. Which of the different ways would be the best? That is a question that only research can answer. The researcher must consider different scenarios and options, and that will allow a determination of which is the best choice for emergency management personnel and trauma centers.