1. International Trauma System Development Program
Trauma registry description and implementation
Lina V. Mata MD., Michel B. Aboutanos MD., MPH, Luke Wolfe MS, Michael Duong, Melvin Denwiddie, Ishaq Sahhar, Kin Leung
Division of Trauma, Critical Care and Emergency Surgery- Virginia Commonwealth University
BACKGROUND
Trauma is a global epidemic. Approximately 5 million people worldwide die from injuries yearly, accounting for 9% of the world’s deaths. Latin American region is faced with the challenges and pressures of health care inequities and scarcity of resources. There is an urgent need to provide both essential and cost effective trauma care. However, a major impediment to system development and provision of essential trauma care is inadequate or nonexistent data.
OBJECTIVES
Development and implementation of an injury surveillance tool to evaluate injury data as well as internal and external resources to promote Trauma System development and quality improvement programs for trauma care in LMIC.
METHODS
An accessible regional web-based trauma registry has been developed by ITSDP; the international component of the division of trauma, critical care and emergency surgery at VCU.
TR Characteristics:
Ability to function at a local/hospital, regional, national level and serve as an international/global injury data bank through its multilingual capacity.
Website access for settings with internet (urban) connection or through software installation where internet connectivity is limited or unavailable.
Access is firewall protected, user restricted and requires a username and encrypted password to safeguard patient information and decrease risk of breach of patient confidentiality.
Administrative function to create users and assign user roles; permitting control of personnel access.
Quality control analysis system; reviews erroneously entered or indispensable missing elements, restricting continuance of data entry until corrected.
Integration of the International Classification of Diseases (ICD-10) search engine allows to promote international comparability in the collection, processing, classification, and presentation of these statistics.
250 data elements are available for the capture of information distributed in different tabs. For areas with minimal resources, the Trauma Registry highlights 50 recommended essential elements that should be captured, based on resource availability.
Trauma Scores such as AIS, ISS, RTS and OIS are also fields captured on this registry.
A reports module with advanced graphics system allows the generation of fixed or modifiable reports as well to download data to an excel file for further statistical analysis.
RESULTS
In the initial pilot phase 10 countries from Latin America will be selected for implementation and training on the use of this essential tool. At the moment the registry has been implemented successfully in 4 hospitals in Latin America..
Table 1. Patients registered per hospital in 2012
Colombia
Two level I trauma centers in Cali, Colombia were trained, during October During December 2012 the main trauma hospital in Medellin Colombia also implemented the registry..
Training was conducted in a two day period to a group of 14 people:
Paramedics
Statisticians
Epidemiologist
Training was conducted in a 2 day period which included site evaluation, presentation on trauma systems, access to the registry and training on how to use the trauma registry module and how to generate reports.
Registry Training Panama City, Panama 2012
Panama
During February 2011, a smaller level I hospital in Panama City adapted the registry. The registry team differed in that members were either resident doctors or nurses.
CONCLUSION
In the near future the trauma registry will allow an accurate estimation of the burden of injuries and will act as a source of data needed for public health surveillance and interventions.
It will allow for monitoring, evaluation and auditing of the quality of trauma care for injured patients and application of potential corrective strategies.
Government awareness will allow planning of trauma systems.
Further evaluations of the impact of this injury surveillance tool through audit filters will help health care institutions identify if established trauma care standards, implemented as corrective strategies are being met.
Trauma and critical care fellows
Medical students
YEAR
HOSPITAL
# OF PATIENTS
ENTERED
2012
Colombia Hospital 1
5316
Colombia Hospital 2
8917
Panama Hospital 1
575