Trauma and Surgical Initiative in Santa Cruz, Bolivia

The Northwestern Trauma and Surgical Initiative (NTSI) is soliciting technological assistance for a number of quality improvement projects in Santa Cruz, Bolivia. Most pressing, we have a trauma registry implemented at six hospitals in Santa Cruz that has an outdated online platform making it very difficult to download analyzable data. It also does not have an offline capacity, limiting the frequency and location of data upload at the hospitals. We are currently in the process of incorporating the elements of the trauma registry into a unified Emergency Department Medical Record to make data collection easier and are looking to simplify the data entry and analysis process. This new platform would also be useful for the management of a general surgery operative registry that is currently being implemented.

We are also working to strengthen the prehospital system with a central call center and a coordinated ambulance dispatch. Currently, most prehospital communication is based on cellular messaging, and the prehospital and inter-hospital system for arranging transfers only has one functioning telephone line. Need for low-resource, technologic innovation and goals for future systemic improvements include multiple call reception, live-tracking of ambulance location, in vivo hospital bed availability, an electronic patient triage system, and a more sophisticated method of communication between the central command center, ambulances, and hospitals.

By way of background, the NTSI ( is a research lab founded by Dr. Mamta Swaroop, a trauma and critical care surgeon at Northwestern University. The overarching mission of the Initiative is to evaluate and strengthen trauma networks and surgical capacity in low resource settings. It has been estimated that 8 out of the 20 top causes of prehospital death are related to trauma in Santa Cruz, Bolivia. The State Department of Health (SEDES) has prioritized trauma care in the region and has partnered with the NTSI to move supporting legislation and research projects forward.

Thank you to the E4C editors for creating such a collaborative community. Please direct any questions, inquiries, or assistance proposals to the current in-country fellow, Dr. Erica Ludi (

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