scholarly journals Implementation of a Hospital-based Trauma Registry in Santa Cruz de la Sierra, Bolivia: Methodology, Preliminary Results, and Lessons learned

2016 ◽  
Vol 5 (2) ◽  
pp. 101-112 ◽  
Author(s):  
Lina V Mata ◽  
Marissa A Boeck ◽  
Kevin J Blair ◽  
J Esteban Foianini ◽  
Henry B Perry ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Trauma Registry ◽  
Capture Rate ◽  
Essential Elements ◽  
Lessons Learned ◽  
Santa Cruz ◽  
Middle Income ◽  
Preliminary Results ◽  
Trauma Registries ◽  
Icd 10

ABSTRACT Aim Five million annual global deaths are attributable to injuries. Yet, a lack of reliable data leaves the true magnitude of injuries unknown in many low- and middle-income countries (LMICs), like Bolivia. Trauma registries provide a means of acquiring these data. We sought to evaluate methodology, preliminary results, and lessons learned during the implementation of a pilot, hospital-based trauma registry at one facility in Santa Cruz de la Sierra, Bolivia. Materials and methods Data collection occurred from January to September 2015 at Clínica Foianini, a private, 50-bed, third-level facility in Santa Cruz. A paper trauma registry form based on the Panamerican Trauma Society's (ATS's) essential elements model was utilized. Trained nurses completed forms at a trauma patient's initial hospital presentation. Results were analyzed via descriptive statistics. Results The registry produced 91 forms over 8 months. An ICD-10 diagnosis code search of hospital visits showed 2,816 eligible patients, with a registry capture rate of 3.2%. Most were males (59.3%) in their mid-20s with head contusions (19.8%), penetrating/lacerating upper extremity (11.0%) or head (7.7%) wounds, or upper extremity fractures (6.6%). Many forms were missing critical data, with average omissions of 12.5 per form (26.0% of questions) and 23.7 per question (26.0% of subjects). Errors averaged 1.0 per form (2.1% of questions) and 2.0 per question (2.2% of subjects). Conclusion Early efforts to implement a paper-based trauma registry at one Bolivian hospital highlight areas for improvement, mainly within education, training, and oversight. Lessons learned will inform long-term objectives to make the registry a standard hospital program across the city, and eventually throughout Bolivia, arming decision-makers with data for targeted trauma initiatives that save lives. Clinical significance These results provide insight into trauma registry implementation in LMICs, which serves to further inform the Bolivian program and can be applied to comparable initiatives in similar settings. How to cite this article Boeck MA, Blair KJ, Foianini JE, Perry HB, Mata LV, Aboutanos MB, Haider AH, Swaroop M. Implementation of a Hospital-based Trauma Registry in Santa Cruz de la Sierra, Bolivia: Methodology, Preliminary Results, and Lessons learned. Panam J Trauma Crit Care Emerg Surg 2016;5(2):101-112.

scholarly journals Utility of an orthopaedic trauma registry in Ghana

2021 ◽  
Vol 55 (3) ◽  
pp. 213-220
Author(s):  
Elissa K. Butler ◽  
Dominic Konadu-Yeboah ◽  
Peter Konadu ◽  
Dominic Awariyah ◽  
Charles N. Mock
Keyword(s):  
Quality Improvement ◽  
Data Quality ◽  
Trauma Registry ◽  
Motor Vehicle ◽  
Categorical Variables ◽  
Trauma Patients ◽  
Orthopaedic Trauma ◽  
Middle Income ◽  
Trauma Registries ◽  
Vehicle Collision

In most low- and middle-income countries, trauma registries are uncommon. Although institutional registries for all trauma patients are ideal, it can be more practical to institute departmental registries for specific subsets of patients. Komfo Anokye Teaching Hospital (KATH) has started a locally developed, self-funded orthopaedic trauma registry. We describe methods and experiences for data collection and examine patient and injury characteristics, data quality, and the utility of the registry. Of 961 individuals in the registry, 67.9% were males, and the median age was 40 years. Motor vehicle collision (23.3%) was the most frequent mechanism of injury. Lower extremity fractures were the most common injury (60.6%), and 43.9% of injuries were managed operatively. Data quality was reasonable with missingness under 10% for 13 of 14 key variables, with inconsistencies of dates of injury, admission, treatment, and discharge in 9.1% of cases. However, the type of operation was missing for 73.2% of operative cases. Despite these limitations, the registry has been used for quality improvement and to successfully advocate for resources to improve trauma care. The registry has been improved by adding more detailed outcome variables, creating a standardisedcodebook of categorical variables, and adding more fields to allow for multiple injuries. In conclusion, it is practical and sustainable to institute a locally developed, self-funded orthopaedic trauma registry in Ghana that provides data with reasonable quality. Such a registry can be used to advocate for more resources to care for injured patients adequately and for quality improvement.

scholarly journals Tobacco intervention research in low- and middle-income countries: lessons learned and future directions

2016 ◽  
Vol 11 (2) ◽  
pp. 61-64 ◽  
Author(s):  
Kenneth D. Ward
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Tobacco Cessation ◽  
Tobacco Dependence ◽  
Lessons Learned ◽  
Future Directions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Tobacco Intervention

Treating tobacco dependence is paramount for global tobacco control efforts, but is often overshadowed by other policy priorities. As stated by Jha (2009), “cessation by current smokers is the only practical way to avoid a substantial proportion of tobacco deaths worldwide before 2050.” Its importance is codified in Article 14 of the Framework Convention on Tobacco Control (FCTC), and in the WHO's MPOWER package of effective country-level policies. Unfortunately, only 15% of the world's population have access to appropriate cessation support (WHO, 2015). Moreover, parties to the FCTC have implemented only 51% of the indicators within Article 14, on average, which is far lower than many other articles (WHO, 2014). Further, commenting on the use of “O” measures (Offer help to quit tobacco use) in the MPOWER acronym, WHO recently concluded, “while there has been improvement in implementing comprehensive tobacco cessation services, this is nonetheless a most under-implemented MPOWER measure in terms of the number of countries that have fully implemented it” (WHO, 2015). To the detriment of global tobacco control efforts, only one in eight countries provides comprehensive cost-covered services, only one in four provide some cost coverage for nicotine replacement therapy, and fewer than one third provide a toll-free quit line (WHO, 2015).

Increasing vaccine uptake in Sudan: Development of a web-based intervention (Preprint)

2021 ◽  
Author(s):  
Majdi Sabahelzain ◽  
Rik Crutzen ◽  
Mohamed Moukhyer ◽  
Hans Bosma ◽  
Bart van den Borne
Keyword(s):  
User Experience ◽  
Vaccine Safety ◽  
Arabic Language ◽  
Essential Elements ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Local Context ◽  
Middle Income ◽  
Web Based ◽  
Content Quality

BACKGROUND WHO described Vaccine hesitancy in 2019 as one of the top 10 threats to global health in high, and low, and middle-income countries. Various communication approaches have been used to engage the public about vaccines and immunization such as mass media and e-health strategies. With the expansion in the use of communication technologies in health in recent years, websites have increasingly been used to support vaccine acceptance and demand and thus increase vaccine uptake. We recently established a web-based intervention called the Tat3im initiative website in Sudan. It aims to increase uptake of vaccines in Sudan by increasing knowledge and addressing issues related to vaccine hesitancy and vaccine safety in the Arabic language OBJECTIVE This article describes the processes that we used to develop and improve this website including the creation of its content. METHODS These processes were informed by using and combining three sources including, Garrett’s user experience framework as a basis for the development, the WHO Vaccine Safety Net's (VSN) criteria for good information practices (i.e. credibility, content (quality and quantity), design and accessibility criteria), and previous relevant research that assessed the local context in Sudan. RESULTS We found that using such evidence as well as combining the VSN's criteria and previous research findings in the five planes of Garrett's framework enabled us to cover many essential elements of user experience and to address issues related to the website’s strategy and content. CONCLUSIONS As the website may be limited due to the high rates of illiteracy as well as relatively low internet use in Sudan, we suggest using social marketing to promote the use of the website as well as monitoring and evaluating the website and users’ experience using different approaches such as visitor traffic and qualitative measures.

scholarly journals Closing the Equity Gap of Access to Emergency Departments of Private Hospitals in Thailand

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Paibul Suriyawongpaisal ◽  
Pongsakorn Atiksawedparit ◽  
Samrit Srithamrongsawad ◽  
Thanita Thongtan
Keyword(s):  
Emergency Care ◽  
Private Hospital ◽  
Financial Incentive ◽  
Gender Disparity ◽  
Lessons Learned ◽  
Care Seeking ◽  
Health Coverage ◽  
Private Hospitals ◽  
Middle Income ◽  
Strategic Policies

Background. Previous policy implementation in 2012 to incentivize private hospitals in Thailand, a country with universal health coverage, to provide free-of-charge emergency care using DRG-based payment resulted in an equity gap of access and copayment. To bridge the gap, strategic policies involving financial and legal interventions were implemented in 2017. This study aims to assess whether this new approach would be able to fill the gap. Methods. We analyzed an administrative dataset of over 20,206 patients visiting private hospital EDs from April 2017 to October 2017 requested for the preauthorization of access to emergency care in the first 72 hours free of charge. The association between types of insurance and the approval status was explored using logistic regression equation adjusting for age, modes of access, systolic blood pressure, respiratory rate, and Glasgow coma scores. Results and Discussion. The strategic policies implementation resulted in reversing ED payer mix from the most privileged scheme, having the major share of ED visit, to the least privileged scheme. The data showed an increasing trend of ED visits to private hospitals indicates the acceptance of the financial incentive. Obvious differences in degrees of urgency between authorized and unauthorized patients suggested the role of preauthorization as a barrier to the noncritical patient visiting the ED. Furthermore, our study depicted the gender disparity between authorized and unauthorized patients which might indicate a delay in care seeking among critical female patients. Lessons learned for policymakers in low-and-middle income countries attempting to close the equity gap of access to private hospital EDs are discussed.

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