Statement of Purpose Identifying injury-related disparities requires accurate patient representation. Understanding data collection/abstraction staff perspective is critical to developing implementation models for integrating health equity data elements into electronic medical record (EMR) and trauma registry systems. To identify barriers/facilitators to collecting/abstracting accurate equity data, we assessed perspectives of national stakeholders in each U.S. region and Emergency Department (ED) registration and trauma registry staff locally.
Methods We conducted a Delphi process with 17 national experts in trauma care systems (included based on recommendations from local and national trauma care leaders) and focus groups with 14 ED patient registration and 9 hospital trauma registry staff. Topics included process of data collection/entry into EMR and data abstraction into trauma registries and barriers/facilitators to accurate collection/abstraction of equity data elements. Audio-recorded focus groups and Delphi recommendations were qualitatively analyzed, and the latter findings were joint-ranked based on feasibility scores and Kappa-based score consistency. Findings were triangulated with ED patient registration observations and trauma registry staff workflow. We developed an implementation model addressing identified barriers/facilitators.
Results Delphi results indicated staff time/investment in process changes as the biggest barriers; facilitators were simplicity and brevity (self-report), and quality improvement checks. ED staff barriers included experiences with patients reacting negatively, and misunderstanding data collection purpose. Cultural-sensitivity training, script for explaining importance of equity data collection, and required data entry for a minimum dataset were facilitators. Trauma registry staff barriers involved needing to search notes for information (e.g., injury address/housing status); staff preferred auto-populated and designated EMR discrete fields.
Conclusions Barriers/facilitators identified differed among national stakeholders, ED registration staff, and trauma registry staff. Successful implementation will involve ongoing staff training, opportunities for patient self-report, and frequent quality improvement checks.
Significance Improved data collection and abstraction processes can increase accuracy of equity measures, facilitating better identification of injury-related disparities.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.