1. Texas EMS & Trauma Registries Hospital Committee September 18, 2015

2. Agenda Registries Overview - Reporting Rules - News - Training Updates Summary of Data Reported in 2013 Questions 2

3. Data Reporting Rules  Texas Administrative Code, Title 25, Part 1, Chapter 103:  Hospitals are to report submersions, traumatic brain injuries, spinal cord injuries and other traumatic injuries within 90 days of discharge  Traumatic injury—ICD-9 codes 800.0 and 959.9, excluding 905-909, 910-924, and 930-939, (for ICD-10 codes see page v of the NTDB Data Dictionary) and admitted to a hospital inpatient setting (for more than 48 hours), or died after receiving any evaluation or treatment or was dead on arrival, or transferred into or out of the hospital  Submersions includes drownings and near drownings (via Web-Data Entry Only)  Registries accepts ICD-9 and ICD-10 Texas EMS & Trauma Registries 3 Injury Epidemiology & Surveillance Branch

4. State has adopted the national standard for EMS & Hospitals -National Trauma Data Bank (NTDB) -We anticipate accepting XML file uploads as of September 29, 2015 -Will continue to accept Legacy (.txt) format until December 31, 2016 New Registries User Guide Available - http://www.dshs.state.tx.us/injury/default.shtmhttp://www.dshs.state.tx.us/injury/default.shtm Injury Severity Score (ISS) Calculator Fixed - Webinar Scheduled on October 7, 2015 Texas EMS & Trauma Registries: News 4 Texas EMS & Trauma Registries Injury Epidemiology & Surveillance Branch

5. Texas EMS & Trauma Registries: Training Texas EMS & Trauma Registries Injury Epidemiology & Surveillance Branch 5 Webinars (http://www.dshs.state.tx.us/injury/MonthlyUpdates.shtm)http://www.dshs.state.tx.us/injury/MonthlyUpdates.shtm  June 10, 2015 – Hospital Web-Data Entry Training  June 24, 2015 – EMS Web-Data Entry Training  July 10, 2015 – Submersion/ISS Calculator Training  July 15, 2015 – Question/Answer/Feedback Session  July 21, 2015 – LTAC/Rehab Web-Data Entry Training  August 12, 2015 – Account Manager Training

6. Texas EMS & Trauma Registries: Training Upcoming webinars : 9/30 - NEMSIS Training 10/1 – NTDB Training 10/7 – ISS Calculator 10/21 – Open Session (Questions/Answers/Feedback) *Dates are subject to change

7. Texas EMS & Trauma Registries: Summary of 2013 Data Nina Leung, PhD Epidemologist

8. Trauma Hospitalizations There were 129,778 hospitalizations reported to the registry in 2013 23,884 (18.4%) reports from facilities in TSA-Q 663 fatalities Mortality Rate: 3% 8 Trauma Hospitalizations

9. Data Quality 9 Trauma Hospitalizations TSA-Q Hospital 2013 Data Completeness (N=23,884) Indicator% Complete Age100% Sex100% Race72% Ethnicity99% Mechanism/Intent99% Injury Severity Score93% Length of Stay100% Alcohol Use82%

10. Hospitalizations by Age and Sex, TSA-Q, 2013 10 Trauma Hospitalizations 62% of hospitalizations were male

11. Hospitalizations by Race and Ethnicity, TSA-Q, 2013 11 Trauma Hospitalizations Hispanic Ethnicity State: 30.5% TSA-Q: 29%

12. 12 Trauma Hospitalizations ISS: Injury Severity Score Hospitalizations by ISS Categories, TSA-Q, 2013 (n=23,884)

13. TBI & SCI Hospitalizations by ISS Categories, TSA-Q, 2013 (N=23,884) There were 76 hospitalizations with diagnoses of TBI & SCI 89.5% of these hospitalizations had ISS ≥16 13 Trauma Hospitalizations

14. Hospitalizations by Median Length of Stay (LOS) and ISS Categories, TSA-Q, 2013 14 Trauma Hospitalizations Overall Median LOS: 2 days

15. Hospitalizations by Alcohol Use, TSA-Q, 2013 15 Trauma Hospitalizations

16. Cause of Injury 16 Trauma Hospitalizations Top 5 Causes of Injury, 2013 RankState#%TSA-Q#% 1.Fall60,82248%Fall9,99542% 2. Motor Vehicle/ Traffic 27,07321% Motor Vehicle/ Traffic 5,24022% 3.Struck by, against10,0178%Struck by, against2,0909% 4.Cut/ Pierce5,6734%Cut/ Pierce1,2605% 5.Transport, other5,1774%Firearm1,0905%

17. Intent, TSA-Q There were 2,722 Assault Injuries 38% were due to struck by, against (n=1,044) 28% were due to firearm (n=765) 18% were due to cut/pierce (n=500) There were 382 Self-Inflicted Injuries 38% were due to firearms (n=147) 34% were due to cut/pierce (n=129) 6% were due to suffocation (n=25) 17 Trauma Hospitalizations

18. Submersions There were 437 submersions reported to the registry in 2013 44 reports from entities in TSA-Q 30% fatal (n=13) 18 Submersions

19. 19 Submersions Submersion Reporting Entity, TSA-Q Type of Entity# Submersions Reported Hospital 39 Medical Examiner 1 Justice of the Peace 4 Missing 0 Total 44

20. Data Quality 20 Submersions *Completeness= proportion of records with valid entry TSA-Q Submersion Data Completeness* (n=44) Indicator TSA-Q complete Age 100% Sex 100% Race 98% Ethnicity 86% Outcome 98% Scene 100% Location 89% Alcohol Use, Adults (n=9) 78% County 100% For Children (n=35) Child Supervised 97% Supervisor Age 89%

21. Age 21 Submersions Drownings by Age, 2013 AgeState%TSA-Q % Child (<15) 30770.25%3579.55% Adult 12628.83%920.45% missing/ unknown 40.92%00% Total 437100%44100%

22. Drownings by Age and Sex, TSA-Q, 2013 22 Submersions 57% of drownings were male

23. Drownings by Race and Ethnicity, TSA-Q, 2013 23 Submersions HISPANIC Ethnicity State: 24.7% TSA-Q: 20.5%

24. Drownings by Month of Incident, TSA-Q, 2013 24 Submersions 66% occurred in June-August

25. Drownings by Scene of Incident, TSA-Q, 2013 SceneState%TSA-Q% Pool/ Hot tub 17439.82%2454.55% Bathtub 306.86%511.36% Natural Body of Water 8419.22%511.36% Other 296.64%12.27% Missing/ Unknown 12027.46%920.45% Total 437100%44100% 25 Submersions

26. Registry Operations Support Team (ROS) Contact Information Team Members: Adrian Conder Tiffany Munoz Jeremy Reynolds Rose Walker Judy Whitfield Email: injury.web@dshs.state.tx.us Telephone Voice Mail: 1-800-242-3562 Please contact us using one of the two methods above. The ROS Team will reply to customers within the first business day of the request. Please visit the Injury Website: http://www.dshs.state.tx.us/injury/default.shtm 26 Injury Epidemiology & Surveillance Branch Texas EMS & Trauma Registries

27. Questions Texas EMS & Trauma Registries Injury Epidemiology & Surveillance Branch 27