Pilot Study of a Software Application to Identify Trauma Registry Inconsistencies.

BACKGROUND: Trauma registries are essential to the functioning of modern trauma centers, and high-quality data are necessary to identify patient care issues, develop evidence-based practice, and more. However, institutional experience suggested existing methods to evaluate data quality were insufficient. OBJECTIVE: This study aims to compare a new software application developed at our trauma center to our existing trauma registry platform on the ability to identify registry inconsistencies (i.e., potential data quality issues). METHODS: We conducted a pilot retrospective cohort study of patients from September 2019 to August 2020 who underwent chart review during a Level I verification visit and had been audited several times for accuracy. Registry records were processed by both validation systems, and registry inconsistencies were recorded. RESULTS: In registry data for 63 patients, the new software found 225 registry inconsistencies, and the registry systems found 153 inconsistencies. The most frequent inconsistencies identified by the new software were missing or unknown procedure start times, with 18/63 (28.6%) patients affected and prehospital supplemental oxygen being blank, with 29/53 (54.7%) patients with prehospital care affected. None of the 10 most common inconsistencies detected with the registry systems were true issues. CONCLUSIONS: This study found the new software application identified 47% more inconsistencies than the standard registry systems, and none of the most frequent inconsistencies detected with the registry systems were true issues pertinent to institutional practice. Centers should consider additional methods to identify registry inconsistencies as existing processes appear insufficient.

Reducing Inpatient Falls Through Simulations With Symptom Burden Devices.

BACKGROUND: In-hospital patient falls are a persistent problem in health care, resulting in increased length of stay and nonreimbursable charges. LOCAL PROBLEM: Although fall prevention programs have decreased inpatient fall rates, our hospital averages 30 falls per month. METHODS: This was a quality improvement project, including a simulation and debriefing. We performed a thematic analysis on the debriefing responses and tracked the inpatient fall rates over 8 months. INTERVENTIONS: We developed and implemented a low-cost simulation to allow bedside clinicians to experience the physiological changes experienced by patients, which contribute to inpatient falls. RESULTS: Fifty-one clinicians participated in the simulation; each expressed an increased understanding in the physical limitations of patients and shared at least 1 technique to help prevent falls for their patient population. The fall rate was reduced by 23.17% in the succeeding 8 months. CONCLUSIONS: Clinicians' awareness of patients' physiological changes can be increased by a low-cost, rapid simulation, resulting in fewer falls.