Kansas Trauma Registry | Users Group Meeting

December 11, 2019

To protect and improve the health and environment of all Kansans

• General Business• New Coordinator Introduction

• Quarterly Submissions

• Registry Questions

• Looking Ahead: 2020• Registry Changes in 2020

• DI Annual Update

• DI V6 Web Registry

• Questions & Comments• Date of next meeting

• Potential topics to be addressed

in next users meeting

To protect and improve the health and environment of all Kansans

Users Group Meeting

To protect and improve the health and environment of all Kansans

• Jill Cavender• From Lawrence, KS

• BA in Global Health from Arizona State University

• Lead Pharmacy Technician for 10+ years at an independent pharmacy in Lawrence

New Trauma Registry Coordinator

Users Group Meeting

To protect and improve the health and environment of all Kansans

Software Update Needed for Local Users Prior to Submission

• DI issued a software patch to

address this issue and all Local

Registry sites should have been

contacted on Monday 12/2 to let

them know the patch was available.

• Patch needs downloaded on ALL

computers that have the registry

installed.

• Submission due date was pushed

back to December 9, 2019.

Quarterly Registry Submissions

Source: NDTB Change Log

To protect and improve the health and environment of all Kansans

Technical Support and Early Submissions

• Please notify us of

any technical issues

as soon as possible.

• Early submissions

are encouraged.

Quarterly Registry Submissions

To protect and improve the health and environment of all Kansans

If I need a record deleted from the registry, how do I go about that?

Registry Questions

Please contact jill.cavender@ks.gov with the trauma number and any records

added in error can easily remove it from the registry for you.

To protect and improve the health and environment of all Kansans

• Yes, if this is caught within 6 months of the submission due date it will show up in the last version of that quarter’s benchmark report.

If we have cases that were missed in the registry, can I

go back in, post-date, and submit them still?

Registry Questions

• Anything later than 6 months after the submission due date will not show up in most of the state reports. However, your site will be able to run reports on the data in Report Runner.

• Anything older than 6 months needs to be addressed with KDHE and the registry vendor, DI, to get them added to the system correctly.

To protect and improve the health and environment of all Kansans

Do e-cigarettes and vaping count as a pre-existing condition/comorbidity for the TQIP value of current smoker?

Registry Questions

• The NTDS definition excludes patients who report

smoking cigars, pipes, or smokeless tobacco. E-

cigarettes and vape pens are considered smokeless

tobacco.

• It is anticipated that this definition will be changing in

the near future.

• According to the TQIP FAQ, vaping and e-cigarettes

do not qualify patients for the pre-existing condition/

comorbidity of Current Smoker.

Source: NTDS FAQs

To protect and improve the health and environment of all Kansans

How is a bar or pub coded using Y92 codes?

Registry Questions

• If the bar or pub also includes, or is part of a restaurant, then code as a

restaurant: Y92.511

• If the bar is part of another establishment such as a casino, hotel, amusement

park, theater, or within a stadium or airport, code using that establishment’s

Y92 code.

• If not coded under another establishment and the bar is accessible to the

public, use the code for other trade/service area: Y92.59

• If a bar is in a private dwelling, then it is always coded as Y92.1 for “private

residence”.

Source: DI Coding Specialist

To protect and improve the health and environment of all Kansans

How would you code motorized scooters or a Segway?

Registry Questions

• These are all treated as motorized mobility scooters when coding (V00.832A).

• Most of those codes will fall under the Pedestrian Conveyance codes, but

some do fall in other areas such as Accidental Falls if the scooter or Segway

was not actively moving (e.g. immobile and the patient fell off).

• In the injury memo, notate the specific type of scooter involved.

Source: DI Coding Specialist

To protect and improve the health and environment of all Kansans

How do you code the MOI if a patient fell from a trailer without injury, then,

as the trailer was being pulled by a motor vehicle, the patient was run over

by a wheel of the trailer, and consequently sustaining injury? Do you code

the cause of injury as primary or code by sequence of events?

Registry Questions

• The primary external cause code should describe the main reason a patient is admitted to the hospital.

• ICD-10-CM codes are accepted for this data element. Activity codes should not be reported for this data element.

Source: National Trauma Data Standard Data Dictionary 2020 Admissions (p. 20)

Child & Adult Abuse

Terrorism Events

Cataclysmic Events

Transport Accidents

The FIRST listed external

cause code should

correspond to the cause of the

most serious diagnosis due

to an assault, accident, or self

harm, following this order of

hierarchy:

To protect and improve the health and environment of all Kansans

Registry Questions

• Patients who had a traumatic event resulting in an injury whileadmitted to your hospital should go through the performance improvement process at your hospital, so then they would not be reported to TQIP.

Source: NTDS FAQs

If a patient falls in-house and sustains an injury should they be included

in the trauma registry or should it be tracked through your PI?

To protect and improve the health and environment of all Kansans

Would you use the toxicology results from the autopsy report on the

alcohol and drug screen fields if the tox screen was not done in the

hospital?

Registry Questions

• TQIP does not collect post-discharge

data, so using an autopsy report for this

data element would not be accurate.

Source: NTDS FAQ

• Per TQIP: No. While the patient’s autopsy report included a positive drug screen result, you should only report positive drug screen results within 24 hours after the patient’s first hospital encounter.

To protect and improve the health and environment of all Kansans

• Smaller facilities with lower trauma designations will typically see quite a bit of redundancy between the ED/Resus and Outcomes tabs.

• In general, if the patient was admitted to your facility, then the final disposition information would be much different from the ED/Resus tab information.

• If the patient was seen in the ED and then transferred out to another facility, it is often the same information between both tabs.

• Though the information is redundant in those cases, we still ask you complete all fields possible.

If we transfer a patient from our ED to a Wichita ED, do I fill out

the ED/Resus tab AND the Outcome tab?

Registry Questions

To protect and improve the health and environment of all Kansans

• If the skilled nursing facility is their permanent residence then you can mark that the patient is being discharged home.

• If they are discharged to a skilled nursing facility for short-term rehab or the possibility of returning to a private residence, then you would indicate SNF.

Source: NTDS 2020 Data Dictionary (p. 158)

What would you use for discharge destination if a patient that lives at a

skilled nursing facility is discharged back to the same SNF? Do you

indicate they discharged home or to the SNF?

Registry Questions

To protect and improve the health and environment of all Kansans

• For now, use “Nurse Practitioner” to indicate a Physician Assistant. DI has noted the choice for PA needs to be added to the 2020 web portal update and we have received confirmation it will be included in that update.

• Note: The choice for “Physician Assistant” is currently available for use in the V5 Trauma Registry.

Web-registry users: For Trauma Team Leader there is no option for a Physician

Assistant. As a smaller, mid-level location, a PA is often our team leader. What option

should I choose in the registry for the most accurate reporting?

Registry Questions

To protect and improve the health and environment of all Kansans

For the Prehospital Triage Rationale fields, will the registry be following the NTDB Data Dictionary’s definition?

Multiple TQIP webinars have spoken to the fact that these need to be identified in the triage section of the EMS Run Report and not just found documented throughout the report.

Registry Questions

We will be following the NTDB Triage

Rationale per the 2020 Data Dictionary

guidelines (p. 52-53). Either the

physiologic/anatomic trauma criteria, or

the MOI criteria for transport to a trauma

center must be found on the scene of

injury EMS Run Report.

To protect and improve the health and environment of all Kansans

• Through the end of 2019: If the patient was NOT admitted to the hospital and NOT

transferred via EMS, then they DO NOT meet the inclusion criteria.

If a patient was not admitted to the hospital, but transferred to a doctor’s

office or a provider at another hospital via private car, does that meet

inclusion criteria for the registry?

Registry Questions

• As of 2020 this will change

and they would meet the

inclusion criteria per the

2020 guidelines (see NTDS

2020 p. V).

To protect and improve the health and environment of all Kansans

• INCLUSION CRITERIA• REMOVED: “Patients who were in a trauma consult or any level of trauma

activation”• This doesn’t change the inclusion criteria that any full trauma team activation needs to be

included in the registry for over/under triage calculations.

NTDB Data Dictionary Updates for 2020:

Looking ahead: Registry Changes in 2020

• INTER-FACILITY TRANSFER

• REMOVED: “or delivered to your hospital by a non EMS transport”

• HOSPITAL EVENT

• RETIRED: Unplanned RETURN to the Operating Room

• NEW: Unplanned VISIT to the Operating Room

Source: NDTB Change Log

To protect and improve the health and environment of all Kansans

DI Annual Update Coming Soon

Looking ahead

The annual update should mostly be minor updates, some to watch out for:

• Hospital Events (as mentioned on previous slide)

• Domestic Violence field – Retired but will remain on our registry

• Physician Assistant added to Trauma Team Leader drop down box on web version

• Patient Homeless option added to Demographics > Pt. Address Info > Alternate Residence

• Occupation fields will only be enabled if the injury is marked as work related

• Decimal points will be added to the field for Total Hospital Charges

More detailed information will follow as soon as it is made available.

To protect and improve the health and environment of all Kansans

New V6 web software coming sometime in 2020

Looking ahead

• V6 will not affect local users

• We have seen some previews, and it should look and function much like the

current version.

• We will know more about the transition to V6 after the first of the year and will

share any information as it becomes available.

• We are working with DI to make sure there will be plenty of education available

for the new version in the form of user guides, videos, interactive training,

webinars, and we will likely include V6 education as part of our on-site training

in the fall of 2020.

To protect and improve the health and environment of all Kansans

Next Users Group Meeting: March 11, 2020 at 1 p.m.

Questions and Comments

What topics would you like to see addressed

in the next meeting?

Users Group Meeting Survey

Meeting minutes will be posted to

kstrauma.org by December 18

Thank you all for joining today, have a

safe and Happy Holiday and a very Happy New Year!