Heterogeneity in Trauma Registry Data Quality: Implications for Regional and National Performance Improvement in Trauma

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• 作者：Christopher J. Dente ; MD ; FACS^a ; ^b ; ^{cdente@emory.edu" class="auth_mail" title="E-mail the corresponding author} ; 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 ; FACSⁱ ; 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 GroupVernon 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
• 关键词：ACS ; American College of Surgeons ; GCOT ; Georgia Committee on Trauma ; NTDB ; National Trauma Data Bank ; PI ; performance improvement ; TQIP ; Trauma Quality Improvement Program
• 刊名：Journal of the American College of Surgeons
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：222
• 期：3
• 页码：288-295
• 全文大小：255 K

文摘

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.