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Implementation and initial analysis of Cardiff Model data collection procedures in a level I trauma adult emergency department. BMJ Open 2022 Jan 06;12(1):e052344

Date

01/08/2022

Pubmed ID

34992109

Pubmed Central ID

PMC8739060

DOI

10.1136/bmjopen-2021-052344

Scopus ID

2-s2.0-85122947943

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.

Author List

Nguyen P, Kohlbeck SA, Levas M, Hernandez-Meier J

Authors

Jennifer Lynn Hernandez-Meier PhD Assistant Professor in the Emergency Medicine department at Medical College of Wisconsin
Michael Levas MD Associate Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Crime Victims
Electronic Health Records
Emergency Service, Hospital
Humans
Surveys and Questionnaires
Violence