Trauma Team care: faster decisions and better outcomes for patients in the Republic of Moldova

When a person arrives at hospital with multiple, life-threatening injuries, every minute matters. At the Institute of Emergency Medicine in Chișinău, Republic of Moldova, a new Trauma Team model means those first minutes are now managed differently.

Introduced in 2024, the Trauma Team approach means that specialists assess and manage the patient simultaneously, rather than working sequentially, with clearly defined roles and a designated team leader coordinating the response. Emergency physicians, traumatologists, surgeons, neurosurgeons and other health professionals are brought together around the patient from the moment the team is activated.

Several specialists may be needed at once, and decisions made in those first critical minutes can shape a patient's chances of survival and recovery.

After two years, results show the difference this approach can make.

Life-changing impact

Among major trauma patients treated at the Institute of Emergency Medicine:

• adjusted odds of in-hospital mortality decreased by 72%
• absolute mortality fell from 14.5% to 7.6%
• emergency department length of stay decreased by 19%, or 42 minutes
• ICU length of stay per admission fell by 62%, or 1.7 days
• overall hospital length of stay decreased by 23%, or 1.3 days.

Behind these figures are people and families for whom timely, coordinated care can make a life-changing difference.

"When a critically injured patient arrives, the right professionals need to be ready to act together, with clear roles and no unnecessary delays. These results show what coordinated action and shared responsibility for the patient can achieve", said Dr Diana Manea, Director of the Institute of Emergency Medicine in Chișinău.

One patient, one team

The Trauma Team is activated according to predefined clinical criteria. Each member has a specific role, while a trained team leader coordinates the response, allowing assessment and interventions to take place simultaneously and helping ensure that life-threatening conditions are addressed as quickly as possible.

For Anatolie, who was admitted to the Institute of Emergency Medicine with severe trauma, what mattered most was knowing that a team was there when he needed it most. "Everything happened very quickly, and I could see that the doctors were working together to help me. I am grateful to the whole team who took care of me and gave me the chance to return to my family."

The approach is part of a broader programme to strengthen clinical capacities in emergency care, implemented by WHO in close partnership with the Ministry of Health and national health institutions, with financial support from Switzerland through the Swiss Agency for Development and Cooperation (SDC). The partnership brings together national leadership and clinical expertise, WHO technical support and sustained Swiss investment to translate evidence and international standards into better emergency care.

An ambitious journey

Across the broader programme, 205 trainings have reached 3109 participants, 19 hospitals have been supported, and 18 international clinical standards have been implemented. The programme also includes clinical mentorship, simulation-based learning and the development of standardized protocols and procedures for acute conditions.

"Two years ago, we began this ambitious journey with the Institute of Emergency Medicine as our pioneering partner. Today, the results demonstrate what can be achieved through strong teamwork and commitment. Building on this experience, we are now adapting the Trauma Team model for Bălți and Căușeni and exploring its application in paediatric care", said Dr Miljana Grbic, WHO Representative in the Republic of Moldova.

Switzerland's support has been instrumental in enabling WHO and national partners to strengthen clinical capacities and translate the Trauma Team concept into everyday practice. "The two-years anniversary is about lives saved. It shows the impact of integrated trauma care, where teamwork and timely decisions can make the difference between life and death. Switzerland is proud to support this partnership and the strengthening of emergency care in Moldova", said Guido Beltrani, Director of the Swiss Cooperation Office in the Republic of Moldova.

For clinicians, the impact of the Trauma Team is visible in everyday practice. "Rapid intervention, simultaneous assessment and multidisciplinary collaboration have changed how we manage patients with multiple injuries. Shorter assessment times and improved survival indicators show that this approach makes a difference", said Dr Radu Gurghiș, Trauma Team Coordinator at the Institute of Emergency Medicine.

The next stage

The experience is now moving beyond the pilot hospital. Clinical processes introduced at the Institute of Emergency Medicine are informing the development of a national trauma standard; the Trauma Team model is being adapted for Bălți and Căușeni, and its potential application in paediatric facilities is being explored.

The aim is to build on what has worked in Chișinău - clear activation criteria, defined responsibilities, trained teams and coordinated clinical decision-making - and to use these lessons to strengthen trauma care across the country. Two years on, the impact can be measured in minutes saved in the emergency department, fewer days in intensive care and, most importantly, better chances of survival for people with severe injuries.

The Trauma Team initiative is part of "Strengthening Clinical Capacities in Emergency Care", implemented by the WHO Country Office in the Republic of Moldova in partnership with the Ministry of Health, national health institutions, and professional and academic partners, with financial support from Switzerland through the SDC.

The programme aims to increase survival from acute conditions through stronger clinical standards, health worker capacities, mentorship, implementation, research, and national and international collaboration. Previous financial support during 2022-2024 was provided by the European Union; the US Agency for International Development and the US Department of State's Bureau of Population, Refugees, and Migration; and the Asia-Europe Foundation.