Mission: Lifeline North Texas STEMI Workshop Data Registry Panel: NCTTRAC Data Collection & Analysis Jennifer Gardner, RN
Mission: Lifeline North Texas STEMI Workshop
Data Registry Panel:NCTTRAC Data Collection & Analysis
Jennifer Gardner, RN
10/8/2014 ©2011, American Heart Association 2
Mission: Lifeline North Texas
Faculty Disclosure Information
Jennifer Gardner, RNData Registry Panel: NCTTRAC Data Collection & Analysis
FINANCIAL DISCLOSURE:Employee of NCTTRAC
UNLABELED/UNAPPROVED USES DISCLOSURE: None
It started with the 1994 Texas Trauma System…
o Texas Administrative Code 157o Established 22 geographic Trauma Service Areas (TSA) o Established Regional Advisory Councils (RACs)o Identified essential components of required regional trauma
planso Includes emergency preparedness
o Outlined trauma facility designation processo Established the Texas Trauma Registry to monitor the Trauma
System and the incidence / costs of injury in Texas.
RAC Mission: support and improve all emergency healthcare through prevention,education, advocacy, research, preparedness, and response.
Reduce morbidity for 19‐counties around the Dallas FortWorth Metroplex, basically 27% of the population of Texas,via collaborative efforts with 167 hospitals, 32 of whichare designated trauma centers, and an estimated 200 EMS/Fireagencies, VFDs and First Responders.
Analyze data using historical data from REG*E the regional patientRegistry software solution for Trauma Service Area‐ E (TSA‐E).
NCTTRAC Zone VisitsZone 1 Sherman, Texas
Zone 2 Denton, Texas
Zone 3 Possum Kingdom, Texas
Zone 4 Ennis/Corsicana, Texas
Zone 5 Plano, Texas
Zone 6 Glen Rose, Texas
Zone 7 DFW Airport, Texas
Zone 8 Richardson/Rowlett, Texas
Texas DSHS State Registry
REG*E
Regional Patient Registry
160Hospitals
151EMS/Fire
REG*E = 3 Million+ records
Standardized Reportsby Committee or Zone
Cardiac Committee Door to Primary PCI Door to Fibrinolytics
Stroke Committee Door to Needle (tPA)% of Door to CT
EMS Committee FMC to door STEMI FMC to door Stroke FMC to EKG
Injury Prevention CommitteeMVA by Age by Zip
(Project: Just Drive)
SPI Committee Double Transfers
Pediatric Committee Pedi X‐rays/CT scans/MRIs Pedi trauma ICU within one hour of identifying the need for ICU care.*
Trauma Committee Run Sheet status (PDCA) Patients 65+ Transfers (ISS >9) ED LOS Less Than 2 Hrs
Air‐Medical CommitteeAir‐Medical Services will be available for
transport within sixty minutes.*
Zones # of Agencies Top Incident Types Code STEMI Code Stroke
Top Causes of Injury by AgeAll REG*E
Located in Patient Registry > Report Writer > Facility> Run Report Status
MOI by Trauma Type All REG*E for 2012 To 2013 To 2014 (current)
Located in Patient Registry > Report Writer > Incident Statistics > MOI By Trauma Type
Cases By Trauma TypeAll REG*E
located in Patient Registry > Report Writer > Sample > Cases By Trauma Type
Located in Patient Registry > Report Writer > Facility > Average Hours in ED by Facility and Calculated ISS ‐ Spline Chart
Average Hours in ED by ISS All REG*E
Project: DSHS CVD/RAC Survey‐ 52 out of 152 EMS agencies responded‐ TSA‐E has Regional Cardiac System Plan in place‐ 100% of EMS agencies at least 50% of units with 12‐lead capability‐ 81‐99% of agencies have at least 50% of staff Advanced Cardiovascular Life
Support (ACLS) trained‐ 81‐99% of agencies have destination protocols to determine where STEMI
patients are transported‐ 81‐99% of agencies perform pre‐hospital cath lab activation‐ 50% of hospitals provide STEMI patient outcome feedback to EMS‐ 50% of EMS agencies report First Medical Contact (FMC) to REG*E‐ 0‐20% of EMS agencies perform pre‐hospital fibrinolytics‐ 1 instance of cardiac data import in REG*E‐ Need STEMI multidisciplinary team or committee that routinely meets toevaluate STEMI performance and make improvement recommendations
• "lack of difficult getting date for stemi vs. other cx"; • "none in the diagnosis field";• "Due to time restrictions, unable to compile at this time"; • "can't compile this information";• "We do not do transfers";• "This data is not tracked in our RMS ‐ Firehouse";• "Chest pain/discomfort was all information available";• "Information not available";
Project: DSHS CVD/RAC Survey
PSAP to Door STEMI:incidents where the cath team was activated
PSAP to Door Stroke:Specialty Team Notification with CVA/Stroke as Primary Impression
Ensure process and submission support reporting
REG*E Stroke & STEMI Reports
EMS/Fire REG*E Data Submission
• Manual data entry
• Import NHTSA/NISE file NEMSIS file DSHS State of Texas file
• Web based service agreement or application program interface (API)
(ePCR vendor interfaces with REG*E and information passes without human interaction)
REG*E Road MapEOY 2014 and 2015 and Beyond….
Annual Static Benchmarking Reports
Regional Standard for ePCR Run Sheet Handoff
Web Based Agreements w/ePCRs and REG*E
Interface between DSHS State Registry and REG*E
Closed Feedback Loop w/outcome PI data for EMS
Enhanced Cardiac and Stroke Reports
NCTTRAC Informatics SOP
Community Forum for knowledge sharing
Data Submission• Please send suggestions or current
challengesReports as Tools• If you collect it, a report can be generated• If you have report challenges, please send them my way
Contact Jennifer Gardner at [email protected]
“The two most powerful warriors are patience and time.”
Support Website• Knowledge Base: for User Help Manual guides• News: for REG*E system updates and outages• Tickets: help desk support and SPI referrals• Community: for open forum discussions
http://support.ncttrac.org