title: Optimising care in a Swiss University Emergency Department by implementing a multicentre trauma register (TARN): report on evaluation, costs and benefits of trauma registries.
abstract: BACKGROUND
  Diagnostic and therapeutic approaches to trauma patients are, depending on experience, equipment and different therapeutic doctrines, subject to wide variations. The ability to compare trauma centres using a standardised trauma register helps to reveal unresolved systemic issues and simplifies the quality management in an Emergency Department (ED).
  
  
  METHODS
  This study describes the selection, implementation and initial evaluation process of an international trauma register in a level 1 ED in a university hospital. Furthermore, first preliminary results and a literature review on the benefits are presented.
  
  
  RESULTS
  The UK-based Trauma and Research Network (TARN) was found to be the most suitable register for a level 1 Swiss trauma centre. In contrast to the majority of the mortality-oriented registry systems, the database is capable of predicting the probability of survival for the referenced patients. Staff and technical adaptations were arranged and regular and reliable data acquisition and entry was ensured within 6 weeks. The University Hospital Bern has performed well from the very beginning and ranks within the top ten hospitals.
  
  
  CONCLUSIONS
  With TARN, an appropriate trauma register has been chosen. First preliminary results have been obtained, and it was concluded that there was a good match between TARN's patient cohort and the Bernese. On the basis of the data entered into the register, the hospital authorities can now plan and perform improvements on the individual aspects of trauma care. Due to an objective comparability, weak points can be identified, lessons can be learned and further improvement can be achieved.
authors.affiliation: Department of Emergency Medicine, Bern University Hospital, Inselspital, Bern CH-3010, Switzerland. max.hartel@insel.ch
authors.forename: Maximilian J
authors.initials: MJ
authors.lastname: Hartel
authors.forename: Nicole
authors.initials: N
authors.lastname: Jordi
authors.forename: Dimitrios-Stergios
authors.initials: DS
authors.lastname: Evangelopoulos
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hasler
authors.forename: Kathrin
authors.initials: K
authors.lastname: Dopke
authors.forename: Heinz
authors.initials: H
authors.lastname: Zimmermann
authors.forename: Aristomenis K
authors.initials: AK
authors.lastname: Exadaktylos
mesh_terms: D019985:Benchmarking / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D006801:Humans; D011786:Quality Control; D058996:Quality Improvement; D012042:Registries; D016019:Survival Analysis; D013557:Switzerland / Q000453:epidemiology; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000401:mortality* / Q000628:therapy