Central Site Circulator

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1 USF/HCA Central Site Trauma Registry Network January Volume 2, Issue 1 Central Site Circulator Full Speed Ahead! USF/HCA Trauma Registry Network has officially begun to use the V5 software! Most of our centers initiated this effort on January 2, 2014 once returning from the holiday time off. So far, the transitions have appeared to be nonproblematic. As with any attempt to develop and grow within a network, opportunities are not always stress-free; patience with the process and growth will be the key to success. The deadline for completion of patient records, data validations and corrections to be made in Trauma One is April 1, There is no April Fool s there as the deadline is a hard date and will not change. Any delay in this first step for data conversion will impact all that follows. DI Spotlight by John Kutcher The USF/HCA Trauma Network is in the process of implementing Digital Innovation s (DI) latest trauma registry platform, Collector V5, in seven FL facilities. The first phase of the Florida project includes a regional system to aggregate all of the facilities and support system-wide evaluation and process improvement. Phase II will include automatic uploads from hospital EMRs into the trauma registry, as well as expansion to include an HCA-wide rollout of a trauma registry to aggregate data from all HCA trauma facilities. The resulting systems will support benchmarking, dashboards and research for HCA stakeholders. DI founder and CEO, John Kutcher, Ph.D., envisions that the project will add a new perspective to trauma research initiatives. As respective nationwide leaders, HCA and DI have unprecedented opportunity to establish the nation s model system-wide trauma registry, stated Dr. Kutcher. USF/HCA Trauma Network Medical Director, Dr. James Hurst, is also looking forward to the opportunities that the V5 software implementation offers. Several months ago, the decision was made to transition all HCA Florida trauma centers to Digital Innovation s version 5, explained Dr. Hurst. Inside this issue DI Spotlight... 2 Data Dictionary/ User Guide... 2 Blake Regional Medical Center... 3 Comic Relief... 3 Educational Tidbits... 4 Statistics... 4 Committee Service... 4 FAQ s... 5 Leadership Corner... 5 Calendar of Events... 6 Critical Thinking... 6 (continued on page 2)

2 DI Products and Service to Support USF/HCA Trauma Network USF/HCA Central Site Trauma Registry Network Central Site Trauma Registry Director: E. Annette O Dell eodell@health.usf.edu (352) (continued from front page) This presented both challenges and opportunities. The challenge was, of course, migrating existing data elements to the new platform. The opportunity, however, far outweighed the challenge. In addition to having a common database for all our Florida trauma centers, the potential of ultimately migrating all of HCA s trauma centers to the same database will create a huge population from which to conduct outcomes and quality research. The link with USF s College of Public Health will further this initiative. The database will be second only to the NTDB in scope. We look forward to the many opportunities this presents us. Headquartered in Forest Hill, MD, DI brings a wealth of experience and innovative technology, emanating from DI s early work on the original Major Trauma Outcomes Study (MTOS) in the late 1980 s. Today, DI is the nationwide leading trauma vendor with software installations in nearly every state, and nearly 1,700 facilities world wide. DI also serves as the development and technology provider for the American College of Surgeons (NTDB & TQIP projects) and the US Department of Defense (worldwide DoD Trauma Registry). DI has established an experienced project team with the active participation by senior managers to ensure the project s success and an ongoing high level of service and support. Annette O Dell, Director of the USF/ HCA Central Trauma Registry, along with her team of experienced registrars, will lead the implementation process of the new system, coordinating plans for software rollout and user education. Newsletter Editors: Vicky Drow vdrow@health.usf.edu (352) Shiloh Lunsford slunsfo1@health.usf.edu (352) Group CTRSupport@health.usf.edu Additional Contributors: John Kutcher, DI Inc. Sue Auerbach, DI Inc. Lynne Greif, BRMC Danielle Richardson, OCRM Mark Anderson, Director of Quality and Outreach You raze the old to raise the new. ~Justina Chen, North of Beautiful Data Dictionary and User Guide Coming Soon to a Facility Near You! The Central Site Team has been working on the 2014 version of the Data Dictionary along with the User Guide for the USF/HCA Trauma Network. These two manuals will work hand in hand. Both manuals will be released to each site in the near future once the final updates have been implemented within the current drafts. 2

3 Comic Relief: Blake Regional Medical Center Facility Spotlight Blake Regional Medical Center by Lynne Grief Blake Medical Center (BMC) is situated on a thirteen-acre tropical campus just blocks from the Gulf of Mexico. We are licensed for 383 beds, staffed for 303 beds, and have an average daily census of 187 patients. The Florida Department of Health designated BMC as a Level II Trauma Center on February 1, Since our provisional status was granted on November 19, 2011, we have cared for 2,080 trauma patients. BMC is the only trauma center in Trauma Service Area 13, which serves Manatee, Sarasota, and Desoto Counties. We have five full-time and two part-time trauma surgeons. Dr. Brian Kimbrell is the TMD, Lynne Grief PhD, RN the TPM, Cindy Tanner RN, BS the Trauma Nurse Coordinator, Maureen O Farrell CSTR, BAS, RHIT the Trauma Registrar, and Dee Payne is the AA. Having just completed our ACS Consultative Visit, we are working diligently through the ACS Verification process. From an EMS trip sheet: PT HAS LARGE OVULATION NOTED TO LEFT KNEE WITH MINOR BLEEDING Patient has left his white blood cells at another hospital She slipped on the ice and apparently her legs went in separate directions in early December The patient left the hospital feeling much better except for her original complaints : Patient s fluid intake is good, mostly beer The patient expired on the floor uneventfully. She has had no rigors or shaking chills, but her husband states she was very hot in bed last night Have you come across any documentation that would grant a smile of two? Send them in...however, please do not send any information with unique patient identifiers in with your entries. entries to CTRSupport@health.usf.edu. 3

4 Educational Tidbits Sign in for the v5 trauma registry and the report writer will be the same through Citrix Please do not use the DI report writer until further notice Please do not access, modify or attempt to work with the TQIP set up functions V5 software does not delete anything for you; this is a builtin safety feature Registry allows for proper case entries Statistics Network Logic Error Occurrence Stated previously, it is imperative that our existing data be completely accurate when transferred to the V5 database. As of September 30, 2013, the Network s trauma registry database contains a total of 12,633 patients. Of those patients, 108 charts contained a logic issue, and there are a total of 127 individual logic errors. In short, 0.85% of our Network patient chart contain a logic errors or 1.01% of our database is reflecting logic errors. This data excludes Lawnwood Regional Medical Center. ED Arrival Date/Time is prior to Injury Arrived From <> Refer Hospital & ED Arrival Date/Time is after Hospital Injury Date/Time is after Hospital Arrived From=Refer Hospital & Transport Mode=EMS Value & EMS Transport Mode=EMS Value & EMS Error Occurrence T is a quick key; while in the date field, t will put in today s date Software allows for up to 27 diagnosis codes; prioritize your entries from highest to lowest in severity If an answer is not in the pick list, more than likely it is not permitted; CTRSupport@health.usf.edu if a question arises / equals Not Applicable or N/A; used when it is not applicable to enter data for a particular field; never used to indicate missing data; many fields will never have an appropriate use of / (N/A); use N/A with discretion? Equals unknown or not documented; used when the information should be available but is not; is appropriate to use for most, if not all fields 4 Committee Service Opportunity We would like to announce that there will be a Data Dictionary/User Guide (DD/UG) Committee formed within the next couple of months. The purpose of this committee will be to provide guidance for changes to the software as well as data definitions and requirements. In order to have the network equally supported and represented by various levels, the committee will be comprised of the following: 1. One Trauma Medical Director 2. One Trauma Program Director 3. One Trauma PI Nurse 4. Two Trauma Registrars 5. USF/HCA Trauma Network Staff a. Trauma Network Medical Director b. Vice President of Trauma Service c. Director of Quality and Outreach d. USF Business Systems Analyst assigned to the USF/HCA Trauma Registry e. Research Director f. Clinical Research Director g. The Central Site Team Participants of this committee would need to be able to faithfully commit to an hour long monthly teleconference beginning in March of Once this committee is formed, the specific timing of the meetings will be arranged according to the schedules of the participants. If you have an interest in participating as a committee member, please send your name and contact information to CTRSupport@health.usf.edu.

5 FAQ s 1. What should we do if a Hospital facility is not in our pick list? the concern with CTRSupport@health.usf.edu with the information. The pick list options were previously provided and approved by FDOH for DI to download into the software. The State of FL will need to address/research any new facilities and EMS providers within the state. 2. If we show IV initiated in the procedures, do we need to show the IV fluids and / or medications given via IV in the medications area? Yes (quick answer) 3. Resus Team and In-House consults? Resus Team is any specialty responding to the ED to see the patient while the patient is in the ED; In-House Consults is any specialty that is requested to see the patient after the patient is no longer in the ED. Please do not collect responses and consults for the same specialty on both screens. Send any questions about the registry or the Network processes to CTRSupport@health.usf.edu. If it is worth doing, it is worth documenting. ~Unknown Leadership Corner by Mark Anderson I was hired in April 2010 as a Trauma Program Director to start the trauma program at Regional Medical Center Bayonet Point (RMCBP) in Hudson, Fl. RMCBP became a provisional trauma center on November 11, 2011 and received full state designation in February My trauma experience began at Legacy Emanuel Medical Center in Portland, Oregon, a state designated and ACS verified Level 1 Adult and Pediatric Trauma Center. I spent 16 years at Emanuel, 11 years as a trauma resuscitation nurse (TRN), and 5 years as a trauma nurse coordinator (TNC). In my 5 years as a TNC, I developed and started a new transfer center and was the PI coordinator. In June 2013, I was presented with the opportunity to become the USF/HCA Trauma Network Regional Trauma Director of Quality and Outreach. During this period our trauma centers have undergone 3 ACS consultative surveys, 1 state survey and one application. The major lesson I have learned from all these recent surveys is the importance of the trauma center s performance improvement program. Problem identification, development of a plan of action, monitoring and reassessing the plan of action and loop closure are the essence of a strong PI program. This is the goal of the USF/HCA Trauma Network. The trauma registry plays a key component in the PI process by providing data to measure our effectiveness as a trauma center. The goal is to integrate PI program documentation into the registry and to eventually become paperless. Currently the USF/HCA Trauma Network has started a Best Practices Committee (BPC) in which the Trauma Medical Directors are developing proactive management guidelines (PMG s). The goal of the BPC is to make collaborative, specific, measurable and evidence based PMG s to be implemented throughout the network. We are starting with Massive Transfusion Protocol (MTP), anticoagulant reversal and geriatric resuscitation PMG s which will all be measurable in the registry. In addition to the BPC, we have started network outreach utilizing the ACS s Rural Trauma Team Development Course (RTTDC). We are in the process of developing a Trauma Neuro Critical Care course for nursing. I look forward to working with you all in the future. 5

6 Calendar of Events: USF/HCA Central Site Trauma Registry Network The Central Site Trauma Registry is devoted to assisting the USF/HCA Trauma Network with delivering an unparalleled public service to support the communities we serve. With efforts to assist the Network in providing patient healthcare, the Central Site Trauma Registry provides an avenue of balance for education and research to support the traumatically injured patient and their families. The Central Site Trauma Registry will provide and cultivate a lifelong structure for research that will enable the physicians and healthcare providers to improve standardized healthcare, provide leadership within the field, and also develop injury prevention knowledge to service our communities. HAPPY NEW YEAR! January 1: Q3 Florida Submission January 8: Registry WebEx Meeting 10:30-12:00 pm January 9: DI TIP Module Training 1:00-2:00 pm January 14: Trauma Registry Updates 10:30-12:00 pm January 15: DI TQIP Users Forum 2:00-3:00 pm CSTR Exam Registration Deadline January 21-23: Report Writer Training (Kendall and Lawnwood only) February 11-13: DI V5 Report Writer Training (Tampa location) February 18: Trauma Registry Updates 10:30-12:00 pm February 28: Q4 TQIP Submission Critical Thinking... All answers relate to the DI Report Writer. After finding all of the words, complete the message with the remaining letters in the order in which they appear from Left to Right, Top to Bottom Clues: Answers the question "Who?" and serves to create a subset of the patient population (5 Letters) Answers the question "How?" and serves to group values for comparison (6 Letters) Reporting method that contains pre-defined, non-editable reports (8 Letters) This type of report provides patient specific information and is similar to a spreadsheet (4 Letters & 5 Letters) This type of report is used for mathematical calculations on aggregate data (10 Letters) This type of query uses a single criterion to create a subset of the patient population (5 Letter) This type of query uses multiple criterion and all criterion must be met for the record to be included in the subset (4 Letters) This type of query uses a range of sequential values listed in one line as opposed to listing each value on a separate line (5 Letters) This report writer tool defines ranges for values that would otherwise be displayed as individual counts; it can never be used alone (5 Letters & 8 Letters) What single word describes the purpose of a query? (6 Letters) What single word describes the purpose of a gather? (5 Letters) This report writer tool allows for the paring of a report, a gather, a query (or any combination thereof) for ease of repetitive use (6 Letters & 3 Letters) T H E G U S F H C A C E E N T R E P O R T J O B L R Q O A L S E I T E T B E A U M W O G U L D L A I K P E E T N O T S H I A N K A R E A V D T E R R Y O C E Y R N A A E A T H E H H I R P T T A V T I E N T C E A A I N D D S D R A D N A T S U E P P O R G T D U A T R D I S N G T H E S B I O O F U T W A R E T L C R C A B A S I C N S E S I T I S O N Y O U G U Y S T O E T A L L Y R O C K I T T A L L T H E W A Y NOTE: The first person to submit a 100% correct puzzle answer will receive a $50.00 Amazon Gift Card! ANSWERS FOR DECEMBER 2013: ACROSS: (2) ECODE (5) TQIP (8) PROPHYLAXIS (9) COMORBIDITIES DOWN: (1) TRANSPORT MODE (3) COMPLICATION (4) AIS SEVERITY (6) LOS (7) FLAG (10) ISS. _!