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Improving Data Collection and Abstraction to Assess Health Equity in Trauma Care

Abstract

Current trauma registries suffer from inconsistent collection of data needed to assess health equity. To identify barriers/facilitators to collecting accurate equity-related data elements, we assessed perspectives of national stakeholders, Emergency Department (ED) registration, and Trauma Registry staff. We conducted a Delphi process with experts in trauma care systems and key informant interviews and focus groups with ED patient registration and trauma registry staff at a regional Level I trauma center. Topics included data collection process, barriers/facilitators for equity-related data collection, electronic health record (EHR) entry, trauma registry abstraction, and strategies to overcome technology limitations. Responses were qualitatively analyzed and triangulated with observations of ED and trauma registry staff workflow. Expert-identified barriers to consistent data collection included lack of staff investment in changes and lack of national standardization of data elements; facilitators were simplicity, quality improvement checks, and stakeholder investment in modifying existing technology to collect equity elements. ED staff reported experiences with patients reacting suspiciously to queries regarding race and ethnicity. Cultural resonance training, a script to explain equity data collection, and allowing patients to self-report sensitive items using technology were identified as potential facilitators. Trauma registry staff reported lack of discrete fields, and a preference for auto-populated and designated EHR fields. Identified barriers and facilitators of collection and abstraction of equity-related data elements from multiple stakeholders provides a framework for improving data collection. Successful implementation will require standardized definitions, staff training, use of existing technology for patient self-report, and discrete fields for added elements.

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Acknowledgements

This work has been conducted for the Injury-related Health Equity across the Lifespan Program (iHeal) at the Harborview Injury Prevention and Research Center. The authors thank all participants in the focus groups and Delphi process.

Funding

This work was supported by the National Institute on Minority Health and Health Resources of the National Institutes of Health (#R21MD013486-01 to Drs. Moore and Rowhani-Rahbar).

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Authors and Affiliations

Authors

Contributions

BM, EB, SA, CS, DD, MSV, AR, and MM contributed to the conception and design of the study. KMC, KM, BM, ES, and MM contributed to data collection. KMC, BM, KM, and MM analyzed the data. KMC led the writing and all authors contributed to interpretation of data for the work and critically revising it for intellectual content. All authors have approved the final version of this article and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Megan Moore.

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Human Subjects approval was granted from the University of Washington Institutional Review Board under study 5571.

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All authors declare they have no conflicts of interest to report.

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This Article is Part of the Topical Collection on Implementation Science & Operations Management

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Conrick, K.M., Mills, B., Mohamed, K. et al. Improving Data Collection and Abstraction to Assess Health Equity in Trauma Care. J Med Syst 46, 21 (2022). https://doi.org/10.1007/s10916-022-01804-4

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  • DOI: https://doi.org/10.1007/s10916-022-01804-4

Keywords

  • Health equity
  • Injury
  • Electronic health record
  • Trauma registry
  • Common data elements