Changes in the National Trauma Data Standard go into effect on January 1. Registry software vendors will handle much of the transition work, but trauma registrars need to pay attention to several key points. In this month’s “Trauma Registry Q&A” column, trauma registry experts from Pomphrey Consulting explain what to do now to prepare your trauma registry for 2017.
Q. I’m new to trauma registry. Could you explain what’s happening?
The National Trauma Data Standard (NTDS) Data Dictionary defines the data elements that make up the National Trauma Data Bank (NTDB). The American College of Surgeons revises the dictionary annually and makes the new standard available in July for the coming year. Registry system vendors need to update their software to reflect the changes. Trauma registrars need to understand the changes and may also need to modify certain aspects of their registry system.
Q. How do I learn about the changes?
The first step is to download the NTDS Data Dictionary for 2017 Admissions and the 2017 NTDS Change Log. To access these resources, visit the NTDS website and look under “Latest News.”
Next, the entire registry team should review the change log together to understand the revisions. Making sure everyone understands the new definitions will help ensure data validity.
Some revisions replace old data elements with new ones. In 2017, for example, the NTDS is retiring “drug use indicator” and replacing it with “drug screen.” This new element is defined as “first recorded positive drug screen results within 24 hours after first hospital encounter.”
Other revisions are simply “additional information” intended to provide registrars with further explanation. For instance, the definition of “initial field GCS – eye” has been changed to provide an example that is more pertinent to eye response.
Q. What are “associated edit checks”?
Close to a quarter of this year’s revisions are classified as associated edit checks. These are “flags” that will be incorporated into the NTDS Validator, which your registry software uses to check data before you submit it to the NTDB.
It is your software vendor’s responsibility to incorporate Validator edit checks into your registry system. You do not need to do anything with these revisions. However, understanding them will reinforce your knowledge of the updated NTDS definitions.
Q. What is the first thing to do right now?
Contact your registry software vendor to schedule installation of the 2017 Validator. Ideally, the Validator will be installed before January 1, 2017. Failing that, get it installed as soon after the beginning of the year as possible.
Why is this important? Say you begin entering patient data in your registry at the start of the year, but your Validator is not installed until the end of February. When you run the submission frequency report on two months’ worth of registry data, you could get thousands of error codes. To resolve those errors, you will then have to wade through hundreds of EMR documents.
In contrast, if you can run the Validator report while a patient’s EMR is still open, you will save significant time and effort. In addition, using the Validator as soon as possible after the start of the year will help you learn the new NTDS definitions better, avoiding mistakes in the first place.
Q. What other actions do we need to take?
Make sure your system picklists reflect the new NTDS definitions. For example, the new “drug screen” data element requires you to capture the specific drugs detected by the screen.
- Some software systems allow users to modify picklists themselves. In that case, go into your system and edit the appropriate picklists to reflect the new field values created for this data element.
- Other systems do not allow users to edit picklists. If that is true of your system, you will need to make sure your vendor updates system picklists for the upcoming year.
You also need to look at how new NTDS definitions might affect mapping in your system. Here’s the issue: You might be collecting additional data elements that are specific to your hospital or another regional registry. Those additional elements might currently be mapped to an NTDS data element via a back-end link. Therefore, changes in the NTDS definition could require you to edit the mapping of non-NTDS data elements.
This is another reason why it is important to install the 2017 Validator as soon as possible. If you have unresolved mapping problems, running a submission frequency report will help you identify incorrectly mapped data elements and work with your system vendor to resolve them.
Trauma Registry Q&A is a monthly column produced in partnership with Pomphrey Consulting, a comprehensive trauma registry company which provides training and trauma registry management. The American College of Surgeons has recognized our Trauma Registrar Mentorship Program for meeting the trauma registrar course requirement of CD15-7. Our course is revised each year to meet any and all ACS NTDB changes, as well as the demands of the ever-changing world of trauma registries. Our program also includes full trauma registrar training in ICD-10-CM and ICD-10-PCS. To visit our website, click here.