How the Trauma Registry Registrar Report Optimizes Data Integrity

Trauma program managers and registry professionals are always looking for new processes, methods, and tools to improve data integrity and department efficiency.

Electronic hospital records (EHRs), ePCRs from EMS, and trauma registries contain vast amounts of data. However, managing this data can often feel overwhelming. Which data points matter most, and how can they be effectively utilized?

Stephanie Becker, CSTR, AEMT, serves as the trauma registrar for the Froedtert Community Hospital Division (CHD). The hospitals in the CHD are Level III and IV institutions that are systematized with the Froedtert Memorial Hospital, a Level I trauma center in Wisconsin. Recently, she shared the Trauma Registry Registrar Report (TRRR)—an Epic Systems report provided by registrars at the partner Level I hospital—to help her team abstract data faster and more accurately while auditing the trauma registry.

History of the Report

As the trauma registry team at the CHD hospitals expanded, Becker recognized the need for detailed documentation to maintain data integrity and onboard new registrars efficiently.

Even seasoned registrars benefit from clear procedures and rules, as every hospital and medical institution may use unique processes and terminology. To address this, Becker initiated a data dictionary project but quickly realized that more comprehensive tools were needed.

Becker reached out to her Level I trauma partner for support and received the TRRR from the registry team. The TRRR satisfied the need for data consistency and accuracy, especially in a large or growing department, by establishing an efficient workflow structure and providing a single-source data authority.

Report Outcomes

After incorporating the TRRR into their workflow, Froedtert CHD registrars saw a notable improvement in both abstraction time and data quality. While most registrars on this team have more than six years of trauma registry experience, the TRRR still significantly enhanced their workflow efficiency and accuracy.

Previously, completing a record without the TRRR required at least two hours, with particularly complex cases taking more than three hours. Since implementing the TRRR, the team now abstracts most charts within an hour, while even complex cases are completed in up to two hours. This represents a one-hour reduction per chart in both categories.

Beyond time savings, the TRRR’s greatest impact lies in the consistency and data quality it brings to the registry process, ensuring reliable and standardized data.

Diving into the TRRR

The Trauma Registry Registrar Report consists of 57 nested tabs that display the most important and frequently used data points. Becker’s team has found that 60-75% of the data points they reference most often fall into this abbreviated list:

Nearly half of Becker’s team reports using between 16 and 35 nested tabs for an average admission case. The other half of the team uses between 36 and 57 nested tabs for the same task. One of the TRRR’s greatest benefits, especially for new hires, is eliminating the need to search extensively for individual data points. For added convenience, the TRRR is available on the main dashboard that Becker’s team sees when users log in.

Patients are qualified to be included in this trauma report in the same way that hospitals select candidates for the trauma registry. Beyond the factors mandated by ACS, state requirements, and other regulatory agencies, hospitals can customize the selection of patients and data points to align with PIPS initiatives and medical research goals.

Key Nested Tabs

One of the most important features of the TRRR is its ability to aggregate data and allow users to drill down into specific data sets with just one click. The purpose of this report is to be able to access and manage relevant patient trauma data with minimal effort in one convenient place. Let that be your guiding principle as you develop your own TRRR process.

Below is a breakdown of some of the most commonly used subtabs in the TRRR. The Froedtert registry teams (both at the Level I and Level III/IV hospitals) found that the layout and data groupings in the report are the most efficient and intuitive for them, but you can adjust to best serve your team’s needs.

Injury/Trauma Description

This tab consolidates incident information, such as whether a seat belt was worn in a motor vehicle crash or a helmet in a motorcycle accident. It also includes consults, blood administration, medication history, and more.  

Anesthesia Report

Surgical information, such as procedure start times and operating room data, is rolled up into this section for easy access.

RN Primary and Second Assessments

This section provides access to critical information such as Glasgow Coma Scale (GCS) scores, Lines, Drains, Airways (LDAs), alcohol screens, and past medical history—all in one place.

Lab Results

A favorite among Froedtert registrars, this tab holds attachments from screenings, blood draws, diagnostic imaging, and other tests conducted since admission. (You can also re-create this in ImageTrend Patient Registry^TM—more on that below.)

Transfer and EMS forms

Conveniently link transfer and EMS forms in this report to reduce time wasted searching for pre-hospital documentation. These encounter-level documents get attached and saved to support data integrity and efficiency. (Patient Registry can also sync this data and documentation from any EMS software into the registry.)

Trauma Data Audits

The Froedtert registry teams use the TRRR along with tools like the Inter-rater Reliability Report (IRRR), Wisconsin data dictionary, and their hospital’s data dictionary to conduct audits. ImageTrend Patient Registry is equipped with agency data dictionaries, like NTDB, as well as your state’s data dictionary. You can also upload your hospital’s data dictionary for robust and automatic verification.

At Froedtert, the trauma data management team audits their Patient Registry using the TRRR as the single-source authority. Becker audits registrars on her team using IRRR scores, and if data fields don’t match up, the data dictionary indicates the point of authority for that data. At Froedtert, for example, Becker turns to the Trauma Registry Registrar Report for the correct information. The IRRR for that specific field is then marked incorrect.

How to Create Your Own TRRR

While Froedtert designed the TRRR in Epic, similar reports can be built in many EHR systems. To locate this report, search for Epic report #80175051. Patient Registry’s configurable dashboards and reporting features allow you to replicate the TRRR directly in the registry, including attachments.

Reach out to an ImageTrend advisor to explore how you can implement and tailor the TRRR for your team’s needs.  

The Difference Interoperability Makes

The Level III and IV Froedtert hospitals use an abridged version of ImageTrend provided to them by the state of Wisconsin, which relies on ImageTrend Patient Registry for their state-level trauma data management and analysis. In contrast, the Level I Froedtert trauma center leverages the full ImageTrend Patient Registry platform, which integrates data from pre-hospital EHRs to simplify data abstraction and verification.

Unlike the Patient Registry used by the Level I trauma center at Froedtert, the Level III and IV community hospitals lack HL7 data syncing capabilities. As a result, their registry teams must manually input data from the EHR into the trauma registry, relying on the TRRR to streamline this process.

The Level I hospital, on the other hand, bypasses this manual step thanks to automated data imports from the Patient Registry. However, it still uses the TRRR as a supplementary tool for trauma data management and audits, benefiting from fewer errors due to the seamless integration of data and documents into its Patient Registry.

Ready to streamline your trauma registry workflows and enhance data accuracy? Learn more about how ImageTrend Patient Registry can support your team with configurable reports and data-driven insights.