Trauma registry coordinator
Ms. Jenny Moskowitz-Barkai
In the Western countries, trauma is the most common cause of death among young people and the main cause of death under the age of 45. The National Trauma Registry was established in 1995 following the recommendations of the Revach Committee. The Registry was established by the late Vita Barell, who had been the Director of the Health Services Research Unit at the Gertner Institute. She actively initiated, established, managed and promoted the registry until her death.
The purpose of the Registry is to improve the quality of care given to trauma victims. At the hospital level: establishment of an accessible database on hospitalized casualties to support the management of care of the injured patients and serve as a tool for the improvement the treatment provided. At the national level: establishment of a national database to monitor the injuries and to assist in the creation of prevention programs and definition of health policy with respect to trauma care in Israel.
Hospitals in the Registry
Nineteen hospitals currently participate in the National Trauma Registery: All six level I trauma centers - Rambam, Beilinson-Schneider, Sheba, Tel Aviv Sourasky, Hadassah-Ein Kerem and Soroka, and 13 regional trauma centers - Hillel Yaffe, Kaplan, Assaf Harofeh, Nahariya, Shaare Zedek, Wolfson, Poriya, Ziv, Barzilai, Haemek, Laniado, Nazareth English, Nazareth Italian.
The data is collected at the hospital by the trauma registrars, monitored by the trauma coordinator, and is the responsibility of the trauma unit director. The data is entered into a computerized system and transmitted to the central database managed by the Israel National Center for Trauma and Emergency Medicine Research at the Gertner Institute.
Criteria for inclusion in the Registry
The trauma registry database includes all injuries classified ICD-9-CM, with diagnosis codes 800-959.9. The Registry records all casualties hospitalized or who died in the Department of Emergency Medicine or who were transferred to another hospital following injury.
The database does not include casualties who die on the scene or on the way to the hospital, who were not hospitalized or who were admitted to the emergency room and hospitalized 72 hours or more after the event.
Size of the central database
The central database of the Trauma Registry currently includes data on over 200,000 casualties hospitalized between 1997-2007 at the various trauma centers in Israel, with approximately 200 fields for each patient.
Type of information collected
The information collected on each of the patients in the Registry includes close to 300 variables: demographic data, circumstances of the injury, type and severity of the injury, treatment at the scene, how patient arrived at the hospital, hospital departments for admission, diagnostic and surgical procedures, trauma resuscitation unit, ICU, length of hospitalization, destination upon discharge, outcome and more.
Quality control and data completeness
The trauma unit and registrars at the hospital are responsible for the quality and accuracy of the data. However, after the data is received from the hospital and entered into the central database, logical and other checks are performed to ensure its quality and completeness. Missing, unclear or erroneous data is corrected and completed.
Every year, each hospital receives a report that compares the hospital's outcomes to the average of comparable hospitals to provide a comprehensive picture of treatment of casualties at that hospital relative to the others.
The data is received by the Israel National Center for Trauma and Emergency Medicine and transferred to a SAS files used for statistical processing.
Data processing is used for quality control, as explained in the previous section, research, information for decision makers, setting policy, etc.
Use of the data in the Registry
The hospitals make ongoing use of the data in the Registry for their own needs. Additionally the National Center for Trauma and Emergency Medicine Research works with numerous organization involved in study of trauma injuries in Israel as well as for the Ministry of Health, the National Road Safety Authority, other government ministries, hospitals, authorities, international organizations such as the WHO, CDC and others. The data is also used in research studies. The data from the Trauma Registry is a tool for decision making at the national level, by the National Council for Trauma, Israeli National Burn Center, National Road Safety Authority and more.
The Trauma Registry data serves as the foundation for publications in the following areas: head injuries, road accidents, home accidents, sports injuries, injuries in children, comparison between Jews and Arabs in terms of injury and hospitalization, terror injuries and more.
Two versions of the reports are issued:
A national report is issued every 2-3 years, distributed widely to decision makers at the Ministry of Health and other government ministries, all hospitals, academic libraries and other organizations interested in the implications of accidents and trauma injuries such as government ministries, the National Insurance Institute of Israel, National Road Safety Authority, insurance companies and more. This report includes the main data on casualties hospitalized at Israeli hospitals and documents trends over the years.
An annual report is issued for the trauma centers participating in the Registry, with limited distribution to directors of trauma units and hospital directors, with data that is relevant to the specific trauma center. The report includes the hospital's data, comparing it to the average of the other trauma centers.