The advantages of the NTDB Trauma Registry cannot be overstated as it serves as a conduit for trauma data that drives the evaluation, prevention, and research of trauma care and can be used for quality control and planning.1 What’s more, the Trauma Registry is designed to provide information that can be used to improve the efficiency and quality of trauma care at all Trauma Centers.
For these reasons and more, Trauma Registry is a requirement for all nationally designated Trauma Centers (Levels I, II, III, and IV). Starting 1/1/2020, the NTDB will expand its inclusion data, which will provide Trauma Centers with better information, but will also increase the number of cases that will need to be added into their database. The impact is expected to increase workload and reduce productivity for Trauma Registrars, as these new inclusions may never have been tracked in any way before.
Inclusion criteria for Trauma Registries for 2020 must now include the following, in addition to all the
other required criteria:
1) Patients directly admitted to your hospital (exclude patients with isolated injuries admitted for elective and/or planned surgical intervention)
a) These patients needed a higher level of care to be provided from the initiating Trauma Center and the patient was transferred to your hospital for this higher level of care.
i) Example: Level III or IV Trauma Center has a burn patient. They are not equipped to handle this situation but stabilize the patient and then directly admits this patient to your Level I facility so that you can properly treat this patient’s burns.
2) Patients who were an in-patient admission and/or observed
a) These patients were brought into the ER of a Trauma Center but not as a trauma patient.
b) Due to their injury, they want to admit the patient as an inpatient or on the observation unit to observe their condition for 24-48 hours, to ensure no other complications occur.
i) Example: Patient was brought into the ER with Loss of Consciousness. They ran all the
tests in ER and patient seems ok, but they want to continue observation for another
day or so to be sure no other symptoms occur before sending them home.
3) Patients who were a trauma consult or any level of trauma activation
a) These patients were brought into the ER of a Trauma Center, but not as a trauma patient.
b) Due to their injury, and after evaluation by the physician, they decided to consult the trauma team.
i) Trauma Consult Example: patient fell 10 feet but only has a couple of scrapes, but due to the height of fall, ED physician wants to consult trauma team to make sure there is nothing else wrong with the patient.
ii) Trauma Level Activation Example: Trauma Center alerted that a gunshot wound (GSW) to the head is coming in. When the patient arrives, it is only a graze wound to the scalp, they stich up and send them home.
4) Patients who sustained one or more traumatic injuries within 14 days of initial hospital encounter
a) Prior to 2010 the NTDB did not have a dened timeline for inclusion.
These Trauma Registry changes will impact workload and productivity. Assess your ability to add 10-15% more inclusions to the database without causing errors or a backlog. Missing deadlines will result in failure to receive valuable benchmarking reports that not only provide insight, but rank your Trauma Center against competitors.
Between now and 1/1/2020, review your staffing support. Ask yourself:
• How will the upcoming changes affect Registrar’s productivity?
• How will this affect staffing needs?
If the answers to these questions indicate a potential hit to staff productivity, consider working with an outsourcing consultant who can offer scalable support of remote Certified Trauma Registrars on
an as-needed basis.
Consider: himagine solutions provides a managed approach to Trauma Registry and will go “at risk” with you, meaning we will face financial penalties if we cannot meet agreed-upon metrics.
1 https://www.ncbi.nlm.nih.gov › pmc › articles › PMC1635421