Implementation and initial analysis of the Cardiff model data collection procedures in a Level I adult trauma emergency department
This article was originally published here
BMJ Open. Jan 6, 2022; 12 (1): e052344. doi: 10.1136 / bmjopen-2021-052344.
OBJECTIVES: Our understanding of community violence is limited by incomplete information, which can potentially be resolved by collecting information on violence-related injuries through health systems in tandem with past data feeds. This study assessed the feasibility of implementing the Cardiff model data collection procedures in emergency departments (ED) to improve multisystem data sharing capabilities and create more representative datasets.
DESIGN: Information collection fields were integrated into the emergency department’s electronic health record (EHR), which collected additional information from patients reporting assault injuries. Emergency nurses were interviewed to assess the implementation and feasibility of information collection. Logistic regression was performed to determine associations between missing location information and patient demographics.
SETTING: 60-bed college-level I adult trauma ED in a large city in the Midwest.
PARTICIPANTS: 2,648 patients tested positive for assault injuries between 2017 and 2020. 198 patients were missed due to age outside the range served by this emergency department. The unselected inclusion of 150 emergency room nurses was interviewed.
KEY OUTCOME MEASURES: Key findings include survey responses from nurses and operating rooms to provide comprehensive injury information across various patient demographics.
RESULTS: Most emergency room nurses believed information collection was aligned with the hospital’s mission (92%), wanted information collection to continue (88%), did not believe information collection information impacted their workflow (88%), and reported taking less than a minute to filter and document violence information (77%). 825 patients (31.2%) provided sufficient information for geospatial mapping. The likelihood of providing complete location information was significantly associated with the patient’s gender, race, means of arrival, support, type of trauma, and year of patient.
CONCLUSIONS: Location-based assault injury information collection procedures can be implemented using the EHR in adult emergency services. Nurses said they were receptive to collecting information. Analyzes suggest that patient level and time variables have an impact on the completeness of information collection. The geospatial information collected can greatly improve the pre-existing data sets of law enforcement and emergency medical systems.