Quality Assurance: Data Completeness & Accreditation The Trauma Audit & Research Network (TARN)
Data completeness % (quantity) Measure of Expected v Submitted number of cases per Hospital Expected no. of cases currently derived 2014 HES data (Hospital Episode Statistics) Data completeness % shown: Website, Clinical Reports & Dashboards Updated every 4 months: End of: March, July & November Quarterly for Dashboards April 16: Data completeness shown as range rather than exact figure Range based on the expected 17% variation of HES data
Data Completeness RANGE calculation Expected submissions: DENOMINATOR 100 Submissions: NUMERATOR 70 Previous Data completeness 70% Data completeness range 70-84% Why a 17% range? >>>>>>>
Improving Data Completeness: HES v TARN 2013 data comparison exercise: Performed Feb-July 2015 Comparison spreadsheet for all Hospitals: Green cases: In both datasets (Submission ID shown) Black cases: In HES dataset only (Hospitals asked to review these missing cases) ‘Not TARN eligible’ field: Completed by Hospital & Fed-back to TARN Missing cases: Issues identified & entered: Increase in Numerator Ineligible cases: Removed from expected no. of cases: Decrease in Denominator
2013 comparison results 44 participating Hospitals >3,936 total cases removed from Denominator Overall 17% Denominator reduction: Used as default range
2013 comparison results REDUCTING DENOMINATOR: Common reasons for removal of cases Rehabilitation only admissions Old injuries Incorrect ICD10 coding Non-traumatic injuries INCREASING NUMERATOR: Commonly missed patient groups Non isolated 65+ Hip fractures Elderly SDH/SAH admitted to medical wards Spinal fractures LOS of exactly 3 day
2014 comparison exercise HES v TARN comparison repeated using 2014 data Comparison based on matching NHS no in both datasets. 3 months’ data used (Feb, July & October) as a representative sample Ineligible cases removed from denominator – reflected in July 16 update Data Completeness then shown as exact (validated) figure rather than a range Exercise repeated when HES15 data received, check Newsletter & website for information
CURRENT ACCREDITATION FIELDS Data Accreditation % Measure of frequency of CORE data field completion CURRENT ACCREDITATION FIELDS Glasgow Coma Score or Intubation/ventilation (Recorded Pre hospital, ED or first GCS – All cases) Incident or 999 Date/time Arrival time Transfer reason, previous/next hospital, request date CT time Operation time, grade, speciality of surgeon, grade of anaesthetist ED doctors: time, grade & speciality Injury detail – proportion of NFS codes *Pre-existing conditions **Pupil reactivity for patients with AIS 3+ (Serious) head injuries (Recorded in any location – for all applicable cases) * Latest Probability of Survival (Ps)14 model ‘Other’ and ‘Not Known’ detrimental to Data Accreditation ** Future Probability of Survival model
Data Accreditation report available on TARN: Missing fields highlighted in red
Data Accreditation shown in Clinical report, website & Dashboards