www.ntdsdictionary.org

www.ntdbdatacenter.com

Three Options

• Direct hospital participation• Third party submits data for hospitals

according to new policies• Third parties and hospitals “share”

data submission task

Shared Data Submission

• Hospital will provide facility information

• Third party may submit data file for hospital

• Either hospital or third party may sign HIPAA agreement

• Both parties will have access to error reports, benchmarking, etc.

Facility Information

Facility Information

• Hospital characteristics

• Trauma level

• Bed size

• Teaching status

• Staffing

• AIS coding versions

• Inclusion/exclusion criteria

Questions Possible with Facility Information

• Injury severity/type by admitting hospital designation (i.e., an assessment of over-under triage).

• The prevalence of injury severity/type presenting to frontier, rural, suburban and urban hospitals by bed size and available resources.

• Procedure types by admitting hospital designation.

• Length of stay by injury type and hospital designation.

• Resource utilization by injury characteristics (e.g., procedures, ICU LOS, insurance, etc.) and hospital size and designation.

• Frequency of inter-facility transfer after hospitalization by injury severity and hospital trauma designation.

• Hospital complications by injury characteristics, hospital designation and patient age.

Benchmarking

• Filtered on trauma level and bed size

• Age• LOS• ICU LOS• ISS• Transfer status• Gender • Discharge disposition

• Discharge status• Principal payment

source• Injury type• Intentionality• Mechanism• Alcohol/drugs• ED disposition

Injury Information in NTDS

• Injury Location (Zip Code or FIPS code)• Trauma type (blunt, penetrating, burn)• Injury intentionality• EMS GCS• ED GCS• EMS Revised Trauma Score• ED Revised Trauma Score• AIS (calculated)• AIS (inferred from ICD-9-CM)• ISS (calculated and inferred)• Co-morbid conditions

Process Information in NTDS

• Total EMS response time

• Total EMS scene time

• Total EMS time

• Total ED time

Outcomes Information in NTDS

• Total ICU length of stay

• Total ventilator days

• Hospital complications

• Total hospital length of stay

• Hospital discharge disposition

• Functional Capacity Index

• Type of ED death

Systems Benchmarking

• Encourage state wide participation

• Define/collect systems demographics

• Establish benchmark report based on NTDS data elements

Systems Information

Criteria: Criteria: ‘‘CompleteComplete’’ Trauma SystemTrauma SystemWest et al, 1988West et al, 1988

1.1. Legal authority to designate/verify trauma centers Legal authority to designate/verify trauma centers

2.2. Formal process to designate/verify centers Formal process to designate/verify centers

3.3. Use of ACS criteria to designate/verify centersUse of ACS criteria to designate/verify centers

4.4. OutOut--of of ––area survey team used area survey team used

5.5. Number of centers limited by needNumber of centers limited by need

6.6. Written triage criteria Written triage criteria

7.7. Ongoing monitoring system Ongoing monitoring system

8.8. Statewide system coverageStatewide system coverage