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Kentucky Trauma Registry . Kentucky Trauma Symposium Lexington, Kentucky November 11, 2010. Andrew Bernard, M.D. Chair , Kentucky Trauma Advisory Committee. Objectives. Trauma system overview Kentucky Trauma Registry Potential uses. Rural Trauma is DEADLY.

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Kentucky trauma registry l.jpg

Kentucky Trauma Registry

Kentucky Trauma Symposium

Lexington, Kentucky

November 11, 2010

Andrew Bernard, M.D.

Chair, Kentucky Trauma Advisory Committee


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Objectives

  • Trauma system overview

  • Kentucky Trauma Registry

  • Potential uses


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Rural Trauma is DEADLY

Rural /Urban: death risk 15:1

MVC deaths inversely to population density

Preventable deaths 30% higher if rural


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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.


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ED Length of StayMarcum and Wallace


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Kentucky’s 1st Level 4 Trauma Center Verification Visit

September 13, 2010; Marcum and Wallace Memorial Hospital, Irvine


Verification team lisa fryman rn dick bartlett kha j d richardson andrew bernard l.jpg
Verification TeamLisa Fryman, RNDick Bartlett, KHAJ.D. RichardsonAndrew Bernard

September 13, 2010; Marcum and Wallace Memorial Hospital, Irvine



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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………


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Kentucky

Trauma

Database

KIPRC

Injury Dashboard

Performance Improvement

Education

Injury Prevention

CDM

“TraumaBase”


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Julia Costich

KIPRC

College of Public Health

Eddie Napier

KIPRC

Kentucky Trauma Registrar



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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


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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


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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.



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Kentucky EMS Information System (KEMSIS)

  • New software being implemented

  • Testing 1Q or 2Q 2011

  • A few agencies to test the system

  • Then expand

  • [email protected]


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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


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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


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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


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Thanks

  • TAC members

  • Lisa Fryman, UK Trauma Coordinator


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Thanks

Dick Bartlett, KHA


Andrew bernard chair ky tac trauma advisory committee acbern00@uky edu 859 913 3613 cell l.jpg
Andrew BernardChair, KY TAC (Trauma Advisory Committee)[email protected] cell


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