Nguyen P, Kohlbeck SA, Levas M, Hernandez-Meier J. Implementation and initial analysis of Cardiff Model data collection procedures in a level I trauma adult emergency department.
BMJ Open 2022;
12:e052344. [PMID:
34992109 PMCID:
PMC8739060 DOI:
10.1136/bmjopen-2021-052344]
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Abstract
OBJECTIVES
Our understanding of community violence is limited by incomplete information, which can potentially be resolved by collecting violence-related injury information through healthcare systems in tandem with prior data streams. This study assessed the feasibility of implementing Cardiff Model data collection procedures in the emergency department (ED) setting to improve multisystem data sharing capabilities and create more representative datasets.
DESIGN
Information collection fields were incorporated into the ED electronic health record (EHR), which gathered additional information from patients reporting assaultive injuries. ED nurses were surveyed to evaluate implementation and feasibility of information collection. Logistic regression was performed to determine associations between missing location information and patient demographic data.
SETTING
60-bed academic level I trauma adult ED in a large Midwestern city.
PARTICIPANTS
2648 patients screened positive for assault injuries between 2017 and 2020. 198 patients were omitted due to age outside the range served by this ED. Unselected inclusion of 150 ED nurses was surveyed.
MAIN OUTCOME MEASURES
Main outcomes include nursing staff survey responses and ORs for providing complete injury information across various patient demographics.
RESULTS
Most ED nurses believed that information collection aligned with the hospital's mission (92%), wanted information collection to continue (88%), did not believe that information collection impacted their workflow (88%), and reported taking under 1 min to screen and document violence information (77%). 825 patients (31.2%) provided sufficient information for geospatial mapping. Likelihood of providing complete location information was significantly associated with patient gender, race, arrival means, accompaniment, trauma type and year.
CONCLUSIONS
It is feasible to implement information collection procedures about location-based, assault-related injuries through the EHR in the adult ED setting. Nurses reported being receptive to collecting information. Analyses suggest patient-level and time variables impact information collection completeness. The geospatial information collected can greatly improve preexisting law enforcement and emergency medical systems datasets.
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