Quality Assurance: Data Completeness & Accreditation The Trauma Audit & Research Network (TARN) Data Collection session

Data completeness % (quantity) Measure of Expected v Submitted number of cases per Hospital  Expected no. of cases obtained from following data sources:  England: HES (Hospital Episode Statistics)  Wales: PEDW (Patient Episode Database Wales)  Ireland: HIPE (Hospital Inpatient Enquiry)  Source data contains ICD10 codes assigned in previous year: Currently 2014  Inclusion criteria applied: Expected denominator derived  Denominator used for guidance only

Data completeness % Measure of Expected v Submitted number of cases  Data completeness % shown: Website & Clinical Reports  Updated every 4 months: End of: March, July & November  Trust and individual Hospital figures  Must be viewed alongside Hospital Survival rate  April 16: Data Completeness now shown as range rather than exact figure  Range based on expected 17% variation of source data.

Data Completeness RANGE calculation Data completeness range70-84% Why a 17% range? >>>>>>>>>>> Expected submissions: DENOMINATOR100 Submissions: NUMERATOR70 Previous Data completeness70%

Improving Data Completeness HES v TARN 2013 data comparison exercise Performed Feb-July 2015

Comparison spreadsheet was produced for all Hospitals  Green: Cases appear in both datasets (Submission ID shown)  Black: Cases appear in HES dataset only (not submitted in TARN) ‘Not TARN eligible’ field: Completed by Hospital & Fed-back to TARN  Missing cases: Issues identified & entered: Increase in Numerator  Ineligible cases: Removed from expected no. of cases: Decrease in Denominator

2013 comparison results  44 participating Hospitals  >3,936 total cases removed from Denominator  Overall 17% Denominator reduction: Used as default range NOTE: Hospitals who participated in 2013 comparison exercise & therefore have an accurate Denominator will have this reflected in their range.

2013 comparison results Common reasons for removal of cases from denominator:  Patients admitted for Rehabilitation only  Incorrect LOS  Old injuries  Incorrect ICD10 coding  Non-traumatic injuries Commonly missed patient groups:  Non isolated 65+ Hip fractures  Traumatic Subdural Haematomas admitted to medical wards  Spinal fractures  LOS of exactly 3 day

Going forward: NEW 2014 comparison exercise  New Comparison report under AUDIT tab  Users can run at any time to identify both:  Missed cases  Ineligible cases (and feed this information back to TARN)  Ineligible cases will then be removed from denominator & reflected in next update  Comparison based on matching NHS nos. in each dataset: England  Other matching fields (gender, age, arrival date): Wales  3 months’ data used (Feb, July & October) as a representative sample Full information can be found on the TARN website: monitoring monitoring

Data Accreditation % Measure of frequency of CORE data field completion CURRENT ACCREDITATION FIELDS Glasgow Coma Score or Intubation/ventilation Incident or 999 Date/time Arrival time Transfer reason, previous/next hospital CT time Operation time, grade, speciality of surgeon, grade of anaesthetist ED doctors: time, grade & speciality Injury detail – proportion of NFS codes *Pre-existing conditions **Pupil reactivity for patients with AIS 3+ (Serious) head injuries Transfer details: Reason for transfer and transfer request date

Data Accreditation%: * Latest Probability of Survival (Ps)14 model ‘Other’ and ‘Not Known’ detrimental to Data Accreditation **Future Probability of Survival model  Data Accreditation report available on TARN: Missing fields highlighted  Data Accreditation breakdown shown in Clinical report & TARN website

Data Accreditation  Data Accreditation report available on TARN  Missing fields highlighted

Data Accreditation breakdown shown in Clinical reports

Questions?