title: Heterogeneity in Trauma Registry Data Quality: Implications for Regional and National Performance Improvement in Trauma.
abstract: BACKGROUND
  Led by the American College of Surgeons Trauma Quality Improvement Program, performance improvement efforts have expanded to regional and national levels. The American College of Surgeons Trauma Quality Improvement Program recommends 5 audit filters to identify records with erroneous data, and the Georgia Committee on Trauma instituted standardized audit filter analysis in all Level I and II trauma centers in the state.
  
  
  METHODS
  Audit filter reports were performed from July 2013 to September 2014. Records were reviewed to determine whether there was erroneous data abstraction. Percent yield was defined as number of errors divided by number of charts captured.
  
  
  RESULTS
  Twelve centers submitted complete datasets. During 15 months, 21,115 patient records were subjected to analysis. Audit filter captured 2,901 (14%) records and review yielded 549 (2.5%) records with erroneous data. Audit filter 1 had the highest number of records identified and audit filter 3 had the highest percent yield. Individual center error rates ranged from 0.4% to 5.2%. When comparing quarters 1 and 2 with quarters 4 and 5, there were 7 of 12 centers with substantial decreases in error rates. The most common missed complications were pneumonia, urinary tract infection, and acute renal failure. The most common missed comorbidities were hypertension, diabetes, and substance abuse.
  
  
  CONCLUSIONS
  In Georgia, the prevalence of erroneous data in trauma registries varies among centers, leading to heterogeneity in data quality, and suggests that targeted educational opportunities exist at the institutional level. Standardized audit filter assessment improved data quality in the majority of participating centers.
authors: Department of Surgery, Emory University, Atlanta, GA; Department of Surgery, Grady Memorial Hospital, Atlanta, GA. Electronic address: cdente@emory.edu.
authors: Christopher J
authors: CJ
authors: Dente
authors: Medical Center-Navicent Health and Department of Surgery, Mercer University School of Medicine, Macon, GA.
authors: Dennis W
authors: DW
authors: Ashley
authors: Department of Surgery, Memorial Health, Savannah, GA.
authors: James R
authors: JR
authors: Dunne
authors: Department of Surgery, Atlanta Medical Center, Atlanta, GA.
authors: Vernon
authors: V
authors: Henderson
authors: Department of Surgery, Georgia Regents University, Augusta, GA.
authors: Colville
authors: C
authors: Ferdinand
authors: Department of Surgery, Wellstar Kennestone Health, Atlanta, GA.
authors: Barry
authors: B
authors: Renz
authors: Department of Surgery, Gwinnett Medical Center, Department of Surgery, Atlanta, GA.
authors: Romeo
authors: R
authors: Massoud
authors: Department of Surgery, Northeast Georgia Health System, Gainesville, GA.
authors: John
authors: J
authors: Adamski
authors: Department of Surgery, Athens Regional Medical Center, Athens, GA.
authors: Thomas
authors: T
authors: Hawke
authors: Department of Surgery, North Fulton Hospital, Roswell, GA.
authors: Mark
authors: M
authors: Gravlee
authors: Department of Surgery, Archbold Memorial Hospital, Thomasville, GA.
authors: John
authors: J
authors: Cascone
authors: Department of Surgery, Hamilton Medical Center, Dalton, GA.
authors: Steven
authors: S
authors: Paynter
authors: Department of Surgery, Georgia Regents University, Augusta, GA.
authors: Regina
authors: R
authors: Medeiros
authors: Department of Surgery, Grady Memorial Hospital, Atlanta, GA.
authors: Elizabeth
authors: E
authors: Atkins
authors: Department of Surgery, Emory University, Atlanta, GA; Department of Surgery, Grady Memorial Hospital, Atlanta, GA.
authors: Jeffrey M
authors: JM
authors: Nicholas
mesh_terms: D000068598:Data Accuracy; D005845:Georgia; D006801:Humans; D008485:Medical Audit; D058996:Quality Improvement; D012042:Registries / Q000592:standards*; D014193:Trauma Centers / Q000592:standards*; D014947:Wounds and Injuries / Q000601:surgery*