Here is the Power Point for the July 9th, 2014 Trauma Registry/CTN Meetings. The slides are also avail
This blog is for gathering ideas for discussion at the December 2014 CTN meeting. Please post your suggestions, ideas, needs for clarification, concerns, case study requests, etc. Also, let us know if you have space available to host the meeting.
Thanks in advance for your input!
Trauma Community and Interested Stakeholders:
Attached is a copy of the signed hearing notice which will be published in the Colorado Register on March 25, 2014.
We want to make you aware of this hearing to consider a change in 6 CCR
1015-4, Chapter Three, the trauma designation rules. The change would be
specific to Level I trauma centers and would affect the required annual patient
The proposed rules are found on our website listed under
"Draft Rules." The hearing notice provides details on how to submit comments to the Board of Health.
Thank you for your attention to this important matter.
Trauma Section Manager
I am in the final classes for my Masters in Health Care Administration and Education (MHA/ED) and need your help. I am researching the need for a trauma education program that focuses on care of the injured patient after resuscitation and in the ICU. Would you please answer 10 simple questions on the survey at the attached link? I would appreciate your input.
Coordinators and Registrars,
CTN is applying for a Systems Improvement Grant to fund training for ICD-10 training for Colorado's trauma coordinators and registrars. We need letters of support from Trauma Medical Directors and other facility representatives to attach to the application. Please send these to Craig Gravitz as soon as possible as the grant application is due in under two weeks. A sample letter is attached that you can use with your facility letterhead or you can write your own.
Two classes will be available, one in the Denver Metro area and a second site to be determined. If your facility has space available to host the training please contact Craig Gravitz or me. The dates that the trainers are available for the classes are August 25-26, and 27-28. The classes will consist of online prep work followed by 2 days in the classroom.
The Trauma Registry Meeting will be held from 11 to Noon in the Carson Room immediately followed by the CTN meeting. A Registry Training Page has been added to this website and the slide presentation Scott Beckley will be using has been downloaded there. Slides and handouts from the 2013 Annual Training are also posted there. See you on Wednesday.
We would like to start using TEG at Good Sam but haven’t been able to get
it passed through med staff. The question I would like to post is what
hospitals in the Colorado trauma system use TEG as part of their coag
studies? I appreciate your help.
Mary E. Shelton, RN, BA, CEN
SCL Health System
Exempla Good Samaritan Medical Center
Lafayette, CO 80026
Volunteers of America was able to match us to a family that was displaced by the recent Colorado Floods. Below is the list of family members and their ages, sizes, and wish lists. This is a large family so all help will be greatly appreciated. You can bring items to the Annual Training and Holiday Party on 12/13/13 or contact Peggy at firstname.lastname@example.org for pick up of items.
The positions of Vice President and Treasurer are up for election this year. We elect these positions to serve starting in even years and President and Treasurer are elected to serve starting in odd years. Nominations are now open and the positions will be elected at the meeting on 12/13/13 which will be held following the annual training.
If you want to start a blog but don't want to become an editor you can post here and I will add it as a new blog for you.
In just the last four months data requests have included:
1. Prehospital dispositions with alcohol and drug use
2. Trauma patients in specific injury zip codes
3. Mechanisms of injury for pediatric patients within specific counties with injury prevention services
4. Traumatic brain injuries and GCS values
5. Volume data for different counties, regions, and trauma designation levels
6. Motor vehicle accidents and patient dispositions
7. Child car seat safety use and injury data
8. ISS values for inpatients, nonsurgical patients, and within age groups
9. A regional study of patients with bleeding disorder or on anticoagulants involved in motor vehicle accidents
The Health Facilities & Emergency Medical Services Division at CDPHE is here to help with you data needs!
Question: How does the State report mortality and adjusted mortality? For adjusted mortality do you remove DOA’s and DNR’s? It appears facilities calculate this a multitude of different ways and we would like some guidance.
CDPHE Answer: DOAs are excluded; however, DNRs were not captured till 2009 and are now in the Co-Morbities field. For mortality rates calculated so far, DNRs would have been included since there was no way to capture them. We are currently evaluating data elements related to DNR but CDPHE does not currently consider DNR for exclusion in risk-adjustment calculations.
Question: Do we still have to track trauma activation/alerts even if that patient had no mechanism of injury?
CDPHE Answer: Holly and the CTNs were tracking trauma over and under activations and the agreement with facilities at the time was that they'd collect data for a year and it would be analyzed. We can decide as a group if we want to continue to collect this or if we want to stop but we see it as a useful predictor of ED disposition. Our question to you......
- Should we continue to collect this data?
Question: If a facility sends you a trauma transfer and the patient turned out to NOT meet trauma inclusion criteria, what do the data look like at the state level? Hosp A would include the patient in their data, but Hosp B would not. It would appear that a trauma patient left Hosp A but never arrived at Hosp B.
CDPHE Answer: Although this likely does not occur often, it happens. However, the CTR is mainly used to review facility-specific info., rather than tracking a patient throughout the system of care. We hope that the CTR data system evolves so that patients can be tracked that way.
CDPHE Answer: For the field, Referring_admit_type.CO, with the following response options,
E: ED care only
NA: Referring facility does not admit patients and has no ER
Ski clinics like Keystone and Breck are considered "E" because they are licensed as CCEC (Community Clinics with Emergency Care). Any CCEC is considered an ED.
NAs are physician's offices or outpatient clinics.
Question: Severe TBI is defined as GCS as < 10. Does this apply to the first GCS in the ED or at any time in the pt’s stay (ED or in patient) that is not caused by meds? The reason I ask about the TBI is that there are cases with an Epidural bleed that has the “lucid interval” and can have a good initial GCS, but later have a serious decline and actually are a severe TBI.
CDPHE Answer (per Holly Heddegaard): It seems reasonable that any GCS <10 should be considered a severe TBI. In the state trauma registry database, we include 3 values for GCS assessments: 1) in the field, 2) on arrival to the ED and 3) one hour post arrival or on discharge from the ED (I know that some hospitals capture more). If any of these assessments show a GCS<10, then I would consider the patient as having a severe TBI.