Heterogeneity in Trauma Registry Data Quality: Implications for Regional and National Performance Improvement in Trauma

Ashley, Dennis W.; Henderson, Vernon J.; Ferdinand, Colville Harvey Bernado; Renz, Barry M.; R, Massoud; Adamski, John H.; Hawke, Thomas J.; Gravlee, Mark; Cascone, John; Paynter, Steven; Medeiros, Regina S.; Atkins, Elizabeth; Nicholas, Jeffrey M.; Vidal, Dayna; Bhatia, Amina; Hill, Karen; Dente, Christopher J.; Johns, Tracy J.; Dunne, James R.; Armola, Rochella; Patterson, James; Roland, Jo; Hawk, Thomas; Sego, Kathy; Bleacher, John; Hannay, Scott; Forsythe, Ashley; McKemie, Clarence; Parris, Melissa A.; Solomon, Gina; Brown, Kim; Sargent, Jim; Garlow, Laura; Postoev, Angelina; Westbrook, Sabrina; Campbell, Robert R.; Lopez, LeAndrea; Mayfield, Kelly; Wood, Thomas O.; Jacome, Francisco; Crosby, Allison L.; Thompson, Michael P.; Napier, Joni; Sy, John; L, McCall; Gioia, Bruce; Thornton, Gail M.; Spencer, Dennis D.; Benton, Michelle; Mullins, Fred; Ingram, Walter L.; O'Neal, J. Patrick; Morgan, Renee

doi:10.1016/j.jamcollsurg.2015.11.035

Cited by 23 publications

(17 citation statements)

References 9 publications

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“…Finally, these inadequate medical records are analyzed and abstracted through the chart review by a distinct person in medical record department ( 22 ). Existing “various data registry hand off” and using a secondary source of data (medical record) instead of a direct interview with the patient in addition to reviewing MR will double the poor data quality, as well.…”

Section: Discussionmentioning

confidence: 99%

Registry Data Coordinator (RDC): a Proper Accessible Strategy for Improving Road Traffic Injury (RTI) Hospital Based Trauma Registry Systems in Developing Countries and Low Income Countries

et al. 2018

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Introduction:Evidence suggested that a significant level of trauma mortality can be prevented using registry system. Aim:This study aimed to improve Kashan Hospital Based Trauma Registry System (KHBTRS) for Road Traffic Injury (RTI). Material and methods:After conducting focus group discussion absence of minimum data set (MDS) and poor data collection process (DCP) were identified as main problems for KHBTRS- RTI. Proposed MDS were surveyed by 20 experts of trauma research center of throughout the Iran. Then approved MDS applied for trauma registry system data base in form of SQL. DCP were reform from prospective data collection (review of medical record) to concurrent (through the interview) approach. Results:Most of participants for MDS approval belonged to clinical group 13(65%). 146 MDS in eighteen main categories were proposed for RTI. The maximum score for each MDS main categories were attributed to body parts injured 220 (100%) and patient vital signs 139 (99.29%) respectively. Pilot testing of KHBTRS- RTI database of 50 (50%) riders indicated fully completeness 50 (100%) for concurrent approach. It was concluded that based on experts’ viewpoints MDS relating to injury nature and place of occurrence have more priority in comparisons to MDS relating to causes of injury. It may attribute to health care providers focus on clinical care and treatment. Conclusion:It was concluded that based on experts’ viewpoints MDS relating to injury nature and place of occurrence have more priority in comparisons to MDS relating to RTI prevention; it may attribute to health care providers focus on clinical care and treatment. To develop injury interventions based on given data, recruitment of professionals as registry data coordinator with specific job description to collect and advocacy of injury external causes data seems imperative.

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Section: Discussionmentioning

confidence: 99%

Registry Data Coordinator (RDC): a Proper Accessible Strategy for Improving Road Traffic Injury (RTI) Hospital Based Trauma Registry Systems in Developing Countries and Low Income Countries

et al. 2018

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“…For example, data quality evaluation mechanisms that are based on standardized quality measurements should be integrated into the data collection process for health care quality assurance 6, 8. In addition, it is important to standardize the definitions of cases and data (e.g., diagnoses and severity), and the data collection and registration processes, with specific training for registrars who perform trauma data extraction 7…”

Section: Discussionmentioning

confidence: 99%

“…In this context, administrative and registry data have significant discordance in information that is used for risk adjustment (coding, severity, or comorbidities) and case ascertainment, which is an essential component of outcome indicators 2, 3, 4, 5. Most comparisons of administrative and registry data consider the registry data as the reference standard,3 although trauma registry data can include various inaccuracies, including record incompleteness or discrepancies from the original medical records, and variability in coding and scoring across hospitals 6, 7, 8…”

Section: Introductionmentioning

confidence: 99%

Comparison of registry and government evaluation data to ascertain severe trauma cases in Japan

Nakahara

Sakamoto

Fujita

et al. 2017

Acute Medicine & Surgery

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AimsAccurate evaluation of health care quality requires high‐quality data, and case ascertainment (confirming eligible cases and deaths) is a foundation for accurate data collection. This study examined the accuracy of case ascertainment from two Japanese data sources.MethodsUsing hospital‐level data, we investigated the concordance in ascertaining trauma cases between a nationwide trauma registry (the Japan Trauma Data Bank) and annual government evaluations of tertiary hospitals between April 2012 and March 2013. We compared the median values for trauma case volumes, numbers of deaths, and case fatality rates from both data sources, and also evaluated the variability in discrepancies for the intrahospital differences of these outcomes.ResultsThe analyses included 136 hospitals. In the registry and annual evaluation data, the median case volumes were 120.5 cases and 180.5 cases, respectively; the median numbers of deaths were 11 and 12, respectively; and the median case fatality rates were 8.1% and 6.4%, respectively. There was broad variability in the intrahospital differences in these outcomes.ConclusionsThe observed discordance between the two data sources implies that these data sources may have inaccuracies in case ascertainment. Measures are needed to evaluate and improve the accuracy of data from these sources.

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“…This we believe, is in no small part, the result of our previously published work on data integrity. 9 Venous thromboembolism prevention and screening practices vary considerably between and within institutions. There is a general lack of consensus in the literature regarding the ideal method and timing of chemoprophylaxis for trauma patients.…”

Section: Discussionmentioning

confidence: 99%

“…Initially, the focus was on data quality for all centers. 9 With this background, the collaborative decided to study VTE because it is a significant quality metric for all trauma centers. Recognizing the importance of prevention of VTE after injury, the ultimate goal of the statewide collaborative is to develop and implement an evidence-based consensus protocol to minimize VTE complications across Georgia trauma centers.…”

mentioning

confidence: 99%

Descriptive Analysis of Venous Thromboembolism in Georgia Trauma Centers Compared with National Trauma Centers Participating in the Trauma Quality Improvement Program

Lassiter

Ashley

Medeiros

et al. 2017

The American Surgeon™

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This study was designed to compare the incidence of venous thromboembolism (VTE) in Georgia trauma centers with other national trauma centers participating in the Trauma Quality Improvement Program (TQIP). The use of chemoprophylaxis and characteristics of patients who developed VTE were also examined. We conducted a retrospective observational study of 325,703 trauma admissions to 245 trauma centers from 2013 to 2014. Patient demographics, rate of VTE, as well as the use, type, and timing of chemoprophylaxis were compared between patients admitted to Georgia and non-Georgia trauma centers. The rate of VTE in Georgia trauma centers was 1.9 per cent compared with 2.1 per cent in other national trauma centers. Overall, 49.6 per cent of Georgia patients and 45.5 per cent of patients in other trauma centers had documented chemoprophylaxis. Low molecular weight heparin was the most commonly used medication. Most patients who developed VTE did so despite receiving prophylaxis. The rate of VTE despite prophylaxis was 3.2 per cent in Georgia and 3.1 per cent in non-Georgia trauma centers. Mortality associated with VTE was higher in Georgia trauma centers compared with national TQIP benchmarks. The incidence of VTE and use of chemoprophylaxis within Georgia trauma centers were similar to national TQIP data. Interestingly, most patients who developed VTE in both populations received VTE prophylaxis. Further research is needed to develop best-practice guidelines for prevention, early detection, and treatment in high-risk populations.

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Heterogeneity in Trauma Registry Data Quality: Implications for Regional and National Performance Improvement in Trauma

Cited by 23 publications

References 9 publications

Registry Data Coordinator (RDC): a Proper Accessible Strategy for Improving Road Traffic Injury (RTI) Hospital Based Trauma Registry Systems in Developing Countries and Low Income Countries

Registry Data Coordinator (RDC): a Proper Accessible Strategy for Improving Road Traffic Injury (RTI) Hospital Based Trauma Registry Systems in Developing Countries and Low Income Countries

Comparison of registry and government evaluation data to ascertain severe trauma cases in Japan

Descriptive Analysis of Venous Thromboembolism in Georgia Trauma Centers Compared with National Trauma Centers Participating in the Trauma Quality Improvement Program

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