title: Establishing hospital-based trauma registry systems: lessons from Kenya.
abstract: OBJECTIVE
  In the developing world, data about the burden of injury, injury outcomes, and complications of care are limited. Hospital-based trauma registries are a data source that can help define this burden. Under the trauma care component of the Bloomberg Global Road Safety Partnership, trauma registries have been implemented at three sites in Kenya. We describe the challenges and lessons learned from this effort.
  
  
  METHODS
  A paper-based trauma surveillance form was developed, in collaboration with local hospital partners, to collect data on all trauma patients presenting for care. The form includes demographic information, pre-hospital care given, and patient care and clinical information necessary to calculate estimated injury surveillance. The type of data collected was standardized across all three sites. Frequent reviews of the data collection process, quality, and completeness, in addition to regular meetings and conference calls, have allowed us to optimize the process to improve efficiency and make corrective actions where required.
  
  
  RESULTS
  Trauma registries have been implemented in three hospitals in Kenya, with potential for expansion to other hospitals and facilities caring for injured patients. The process of establishing registries was associated with both general and site-specific challenges. Problems were identified in planning, data collection, entry processes, and analysis. Problems were addressed when identified, resulting in improved data quality.
  
  
  CONCLUSIONS
  Trauma registries are a key data source for defining the burden of injury and developing quality improvement processes. Trauma registries were implemented at three sites in Kenya. Problems and challenges in data collection were identified and corrected. Through the registry data, gaps in care were identified and systemic changes made to improve the care of the injured.
authors.affiliation: Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA; Department of Surgery, Johns Hopkins Hospital, 720 Rutland Ave, Baltimore, MD 21205, USA. Electronic address: ksteve14@jhmi.edu.
authors.forename: Kent A
authors.initials: KA
authors.lastname: Stevens
authors.affiliation: Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA.
authors.forename: Fatima
authors.initials: F
authors.lastname: Paruk
authors.affiliation: Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA.
authors.forename: Abdulgafoor M
authors.initials: AM
authors.lastname: Bachani
authors.affiliation: Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA; Department of Surgery, Virginia Commonwealth University Medical Center, 1200 E. Broad Street, Richmond, VA 23219, USA.
authors.forename: Hadley H K
authors.initials: HH
authors.lastname: Wesson
authors.affiliation: Kenya Ministry of Health, Afya House, Cathedral Road, P.O. Box 30016-00100, Nairobi, Kenya.
authors.forename: John M
authors.initials: JM
authors.lastname: Wekesa
authors.affiliation: Naivasha District Hospital, PO Box 141, Naivasha, Kenya.
authors.forename: Joseph
authors.initials: J
authors.lastname: Mburu
authors.affiliation: Thika Level 5 Hospital, PO Box 227, Thika, Kenya.
authors.forename: Jonah M
authors.initials: JM
authors.lastname: Mwangi
authors.affiliation: Department of Human Anatomy, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya.
authors.forename: Hassan
authors.initials: H
authors.lastname: Saidi
authors.affiliation: Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA.
authors.forename: Adnan A
authors.initials: AA
authors.lastname: Hyder
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D003625:Data Collection / Q000379:methods; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000639:trends; D005260:Female; D006761:Hospitals; D006801:Humans; D007630:Kenya; D008297:Male; D011159:Population Surveillance; D016730:Program Development; D015397:Program Evaluation; D058996:Quality Improvement; D012042:Registries / Q000592:standards / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000628:therapy
keywords: Developing world; Emergency medical systems; Injury prevention; Trauma care; Trauma registries