According to the American College of Surgeons’ 2022 Standards for the Optimal Care of the Injured Patient, trauma centers should allocate at least 0.5 FTE (Full-Time Equivalent) for every 200–300 annual patient entries that meet NTDS inclusion criteria. This standard acknowledges the critical role that registrars play in maintaining trauma registry integrity and ensuring patient care quality.

However, the ACS also recognizes that registrars have other responsibilities beyond data entry, including:

• Report generation
• Data analysis
• Research assistance
• Meeting various submission requirements
• Data validation before registry acceptance

These additional tasks reduce the time available for patient data collection and highlight the need for additional staff to maintain both accuracy and productivity.

Data validation is a critical aspect of maintaining the quality of trauma registries. The 2022 Standards require all trauma centers to have a written data quality plan with at least quarterly reviews. By sharing data validation results in a central location, Trauma Program Managers (TPMs) and trauma surgeons can continually monitor the accuracy of staff data entry. This ensures that the data used for prevention, performance improvement, patient safety (PIPS), and other vital program aspects remains reliable.

To manage and track productivity, it’s essential to establish a system for monitoring the number of charts closed daily while ensuring accuracy. A simple solution is to use an Excel sheet where registrars can log their work weekly. This productivity tracker should include:

• Trauma Registry Number
• Medical Record Number
• Start Date
• End Time
• ICU Days
• Hospital Days
• Comments (e.g., death, multiple surgeries, anything that impacts time spent on the chart)

By analyzing this data, TPMs can assess both the quantity and quality of work completed, making it easier to identify trends in productivity and areas for improvement.

Registrars work at different speeds, with some prioritizing quick data abstraction while others take a more methodical approach to ensure they capture every detail. It’s essential to account for these differences when setting productivity targets. Accuracy should never be compromised for speed, as the integrity of the data is vital for effective trauma care and program success.

Once the necessary data has been collected, trauma centers can establish reasonable daily chart closure goals that their registrars can realistically meet while maintaining data accuracy. For example, by running reports that show the average Injury Severity Score (ISS), hospital days, and ICU days, you can gain a better understanding of the average time required to process each chart.

This data-driven approach not only ensures that productivity goals are achievable but also provides justification for additional staff if necessary. If trauma cases increase, the workload must be adjusted to ensure that registrars can maintain high-quality data entry without being overburdened.

By using tracked productivity data, trauma centers can clearly demonstrate to administrators when additional staff are needed. This approach ensures that trauma registries remain adequately staffed, especially during times of increased patient volume or when the complexity of cases rises.

Trauma Registry Professionals play a critical role in maintaining the quality of trauma care. Balancing chart closure targets with data accuracy and registrar well-being is essential to fostering a productive work environment.

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