Heterogeneity in Trauma Registry Data Quality: Implications for Regional and National Performance Improvement in Trauma - 03/03/16

Doi : 10.1016/j.jamcollsurg.2015.11.035

Christopher J. Dente, MD, FACS ^a,^b,^⁎ , Dennis W. Ashley, MD, FACS ^f, James R. Dunne, MD, FACS ^g, Vernon Henderson, MD ^c, Colville Ferdinand, MD, FACS ^h, Barry Renz, MD, FACS ^d, Romeo Massoud, MD, FACS ^e, John Adamski, MD, FACS ⁱ, Thomas Hawke, MD ^j, Mark Gravlee, MD, FACS ^k, John Cascone, MD, FACS ^l, Steven Paynter, MD, FACS ^m, Regina Medeiros, RN ^h, Elizabeth Atkins, RN ^b, Jeffrey M. Nicholas, MD, FACS ^a,^b
on behalf of the
GRIT Study Group
Vernon Henderson, MD, Dayna Vidal, RN, Amina Bhatia, MD, Karen Hill, RN, Christopher Dente, MD, Elizabeth Atkins, RN, Dennis Ashley, MD, Tracy Johns, RN, Colville Ferdinand, MD, Regina Medeiros, RN, James Dunne, MD, Rochella Armola, RN, James Patterson, MD, Jo Roland, RN, Thomas Hawk, MD, Kathy Sego, RN, John Bleacher, MD, Karen Hill, RN, Scott Hannay, MD, Ashley Forsythe, RN, Clarence McKemie, MD, Melissa Parris, RN, Romeo Massoud, MD, Jeffrey Nicholas, MD, Gina Solomon, RN, Steven Paynter, MD, Kim Brown, RN, Mark Gravlee, MD, Jim Sargent, RN, Barry Renz, MD, Laura Garlow, RN, Angelina Postoev, MD, Sabrina Westbrook, RN, Robert Campbell, MD, LeAndrea Lopez, RN, Kelly Mayfield, MD, Tina Wood, RN, Francisco Jacome, MD, Allison Crosby, RN, Michael Thompson, MD, Joni Napier, RN, John Sy, MD, Lynnette McCall, RN, Bruce Gioia, MD, Gail Thornton, RN, Dennis Spencer, MD, Michelle Benton, RN, Fred Mullins, MD, Walter Ingram, MD, J. Patrick O'Neal, MD, Renee Morgan

^a Department of Surgery, Emory University, Atlanta, GA
^b Department of Surgery, Grady Memorial Hospital, Atlanta, GA
^c Department of Surgery, Atlanta Medical Center, Atlanta, GA
^d Department of Surgery, Wellstar Kennestone Health, Atlanta, GA
^e Department of Surgery, Gwinnett Medical Center, Department of Surgery, Atlanta, GA
^f Medical Center-Navicent Health and Department of Surgery, Mercer University School of Medicine, Macon, GA
^g Department of Surgery, Memorial Health, Savannah, GA
^h Department of Surgery, Georgia Regents University, Augusta, GA
ⁱ Department of Surgery, Northeast Georgia Health System, Gainesville, GA
^j Department of Surgery, Athens Regional Medical Center, Athens, GA
^k Department of Surgery, North Fulton Hospital, Roswell, GA
^l Department of Surgery, Archbold Memorial Hospital, Thomasville, GA
^m Department of Surgery, Hamilton Medical Center, Dalton, GA

^∗Correspondence address: Christopher J Dente, MD, FACS, Department of Surgery, Emory University, 69 Jesse Hill Jr Dr SE, Suite 302, Atlanta, GA 30303.Department of SurgeryEmory University69 Jesse Hill Jr Dr SESuite 302AtlantaGA30303

Abstract

Background

Led by the American College of Surgeons Trauma Quality Improvement Program, performance improvement efforts have expanded to regional and national levels. The American College of Surgeons Trauma Quality Improvement Program recommends 5 audit filters to identify records with erroneous data, and the Georgia Committee on Trauma instituted standardized audit filter analysis in all Level I and II trauma centers in the state.

Study Design

Audit filter reports were performed from July 2013 to September 2014. Records were reviewed to determine whether there was erroneous data abstraction. Percent yield was defined as number of errors divided by number of charts captured.

Results

Twelve centers submitted complete datasets. During 15 months, 21,115 patient records were subjected to analysis. Audit filter captured 2,901 (14%) records and review yielded 549 (2.5%) records with erroneous data. Audit filter 1 had the highest number of records identified and audit filter 3 had the highest percent yield. Individual center error rates ranged from 0.4% to 5.2%. When comparing quarters 1 and 2 with quarters 4 and 5, there were 7 of 12 centers with substantial decreases in error rates. The most common missed complications were pneumonia, urinary tract infection, and acute renal failure. The most common missed comorbidities were hypertension, diabetes, and substance abuse.

Conclusions

In Georgia, the prevalence of erroneous data in trauma registries varies among centers, leading to heterogeneity in data quality, and suggests that targeted educational opportunities exist at the institutional level. Standardized audit filter assessment improved data quality in the majority of participating centers.

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Abbreviations and Acronyms : ACS, GCOT, NTDB, PI, TQIP

Plan

Methods

Results

Participating centers and overall data

Individual audit filter performance

Change in error rates over time

Discussion

Conclusions

	Disclosure Information: Nothing to disclose.
	Collaborators in the GRIT Study Group are listed in the Appendix.

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Vol 222 - N° 3

P. 288-295 - mars 2016 Retour au numéro

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Heterogeneity in Trauma Registry Data Quality: Implications for Regional and National Performance Improvement in Trauma - 03/03/16

Abstract

Background

Study Design

Results

Conclusions

Plan

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