Establishing hospital-based trauma registry systems: lessons from Kenya

Kent A Stevens; Fatima Paruk; Abdulgafoor M Bachani; Hadley H K Wesson; John M Wekesa; Joseph Mburu; Jonah M Mwangi; Hassan Saidi; Adnan A Hyder

doi:10.1016/S0020-1383(13)70216-X

Establishing hospital-based trauma registry systems: lessons from Kenya

Injury. 2013 Dec:44 Suppl 4:S70-4. doi: 10.1016/S0020-1383(13)70216-X.

Authors

Kent A Stevens¹, Fatima Paruk², Abdulgafoor M Bachani², Hadley H K Wesson³, John M Wekesa⁴, Joseph Mburu⁵, Jonah M Mwangi⁶, Hassan Saidi⁷, Adnan A Hyder²

Affiliations

¹ 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.
² Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA.
³ 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.
⁴ Kenya Ministry of Health, Afya House, Cathedral Road, P.O. Box 30016-00100, Nairobi, Kenya.
⁵ Naivasha District Hospital, PO Box 141, Naivasha, Kenya.
⁶ Thika Level 5 Hospital, PO Box 227, Thika, Kenya.
⁷ Department of Human Anatomy, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya.

PMID: 24377783
DOI: 10.1016/S0020-1383(13)70216-X

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.

Keywords: Developing world; Emergency medical systems; Injury prevention; Trauma care; Trauma registries.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Accidents, Traffic / statistics & numerical data*
Data Collection / methods
Emergency Service, Hospital / organization & administration*
Emergency Service, Hospital / trends
Female
Hospitals
Humans
Kenya
Male
Population Surveillance
Program Development
Program Evaluation
Quality Improvement
Registries* / standards
Registries* / statistics & numerical data
Wounds and Injuries / epidemiology*
Wounds and Injuries / therapy