management of road traffic injuries in healthcare facilities: challenges, policy recommendations, and implications for policymakers

Road traffic accidents in iran impose a considerable burden of mortality and disability. despite widespread attention to prehospital interventions, the quality and coherence of trauma patient management in healthcare facilities remains one of the critical yet less well-organized components of the care continuum. this policy brief aims to identify key challenges in hospital-based trauma management and present actionable options to reduce preventable adverse outcomes. this study employed an analytical-participatory approach, beginning with a brainstorming session with selected stakeholders from tehran university of medical sciences and a review of the evidence. three authors independently analyzed the session data and existing evidence, and through subsequent consensus meetings, shared challenges were identified. moreover, drawing on the same data, best available evidence, and the authors' initiative, actionable policy options were formulated. challenges were identified at four levels: 0) resource-level (workforce shortages, inadequate payment systems, technological and equipment deficiencies, and consumable mismanagement), 1) operational and clinical (team coordination failures, overcrowding, and inconsistent protocol implementation), 2) systemic and referral (fragmented care pathways, inadequate post-discharge follow-up, and scattered data systems), and 3) governance and intersectoral (weak accountability, insufficient continuous quality improvement, and lack of structured inter-organizational collaboration). four complementary options were proposed: strategic resource optimization and sustainable trauma financing, standardizing emergency response to severe trauma, integrating the care pathway from admission through discharge and follow-up, and establishing performance monitoring and quality improvement mechanisms within hospitals. prioritized and phased implementation of these options, tailored to hospital capacity, can reduce preventable delays, improve clinical outcomes, and strengthen post-hospital follow-up.