The American College of Surgeons requires that trauma centers collect and enter data into the National Trauma Data Registry in compliance with the National Trauma Data Standard. ProMedica supports employment of 4 trauma data analysts who are responsible for entering information in a timely manner, validating the data, and analyzing data to evaluate established benchmarks and support the performance improvement and patient safety process. Historically, these analysts were located on-site at ProMedica Toledo Hospital. In 2017, a proposal was developed including modifications to data collection to streamline processes, move toward paperless documentation, and allow for the analysts to telecommute. To measure the effect of these changes, the timeliness of data entry, rate of data validation, productivity, and staff satisfaction were measured. After the transition to electronic data management and home-based workstations, registry data were being entered within 30 days and 100% of cases were being validated, without sacrificing effective and efficient communication between in-hospital and home-based staff. The institution also benefitted from reduced expense for physical space, employee turnover, and decreased employee absenteeism. The analysts appreciated benefits related to time, travel, environment, and job satisfaction. It is feasible to transition trauma data analysts to a work-from-home situation. An all-electronic system of data management and communication makes such an arrangement possible and sustainable. This quality improvement project solved a workspace issue and was beneficial to the trauma program overall, with the timeliness and validation of data entry vastly improved.

Trauma centers monitor under- and overtriage rates to comply with American College of Surgeons Committee on Trauma verification requirements. Efforts to maintain acceptable rates are often undertaken as part of quality assurance. The purpose of this project was to improve the institutional undertriage rate by focusing on appropriately triaging patients transferred from outside hospitals (OSHs). Trauma physicians received education and pocket cards outlining injury severity score (ISS) calculation to aid in prospectively estimating ISS for patients transferred from OSHs, and activate the trauma response expected for that score. Under- and overtriage rates before and after the intervention were compared. The postintervention period saw a significant decrease in overall overtriage rate, with simultaneous trend toward lower overall undertriage rate, attributable to the significant reduction in undertriage rate of patients transferred from OSHs. Prospectively estimating ISS to assist in determining trauma activation level shows promise in managing appropriate patient triage. However, questions arose regarding the necessity for full trauma activation for transferred patients, regardless of ISS. It may be necessary to reconsider how patients transferred from OSHs are evaluated. Full trauma activation can be a financial and resource burden, and should not be taken lightly.