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Kentucky Trauma Registry

Kentucky Trauma Registry

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Kentucky Trauma Registry

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  1. Kentucky Trauma Registry Kentucky Trauma Symposium Lexington, Kentucky November 11, 2010 Andrew Bernard, M.D. Chair, Kentucky Trauma Advisory Committee

  2. Objectives • Trauma system overview • Kentucky Trauma Registry • Potential uses

  3. Rural Trauma is DEADLY Rural /Urban: death risk 15:1 MVC deaths inversely to population density Preventable deaths 30% higher if rural

  4. Trauma System Components Verified Trauma Centers Training- EMT’s, nurses, and doctors Protocols-EMS & hospital treatment & transport Datacollection and surveillance Performance Improvement (PI) Injury prevention Trauma system legislation in 2008.

  5. 1 3 1 1 1 4 4 4 3 2 4 3 4 3

  6. ED Length of StayMarcum and Wallace

  7. Kentucky’s 1st Level 4 Trauma Center Verification Visit September 13, 2010; Marcum and Wallace Memorial Hospital, Irvine

  8. Verification TeamLisa Fryman, RNDick Bartlett, KHAJ.D. RichardsonAndrew Bernard September 13, 2010; Marcum and Wallace Memorial Hospital, Irvine

  9. Kentucky Trauma Registry

  10. EMS Data Can Answer: • Where did it occur? • How? • Who responded? • Who transported? • Where? • What happened in route? • Were the decisions/actions correct? • What was disposition? In state? Out? • Much more………

  11. Kentucky Trauma Database KIPRC Injury Dashboard Performance Improvement Education Injury Prevention CDM “TraumaBase”

  12. Julia Costich KIPRC College of Public Health Eddie Napier KIPRC Kentucky Trauma Registrar

  13. Kentucky Registry Report 9-21-10

  14. First Report • 13423 records from 2008 and 2009 • 5 basic questions initially investigated: • patients moving up the system – evidence of 'right patient, right place, right time’ • ED discharge characteristics • overview of data from new level 4’s • In/out-of-state movement • duration in referring facility vs. community hospital

  15. Items Investigated • ICD9 (diagnosis) and AIS distributions • mortality rate • time spent in hospital • total time prior to hospitalization • age (> 55, <15) influences • pre-hospital transport (Ambulance or Helicopter) characteristics • mechanism of injury • County of residence compared to county of injury • hypotension in the ED • ED disposition to OR or ICU

  16. Conclusions-First Report • Appropriate movement in some patient groups. • Evidence of the impact that hypotension plays in mortality. • Apparent reduction in mortality for certain diagnoses for patients transferred in.

  17. Who should be contributing to the registry?

  18. Kentucky EMS Information System (KEMSIS) • New software being implemented • Testing 1Q or 2Q 2011 • A few agencies to test the system • Then expand • kemsis@KCTCS.edu

  19. How can the registry help me? • Local PI • EMS • Hospital • Regional PI • Leverage revenue and funding • Public education/media/marketing • Focus your prevention efforts • Research

  20. How can I help the registry? • Trauma centers: legislated • Non-trauma hospitals: • External force ICD 9 codes • ‘e-codes’ • 800-999 • EMS: prepare for KEMSIS

  21. Conclusions • Trauma systems save lives • Hospitals, EMS, protocols, data, training, PI • Kentucky has a trauma outcome problem • Rural • Immature system • You are the answer • We need complete, accurate data • We need to ask questions

  22. Thanks • TAC members • Lisa Fryman, UK Trauma Coordinator

  23. Thanks Dick Bartlett, KHA

  24. Andrew BernardChair, KY TAC (Trauma Advisory Committee)acbern00@uky.edu859-913-3613 cell