Mission: Lifeline North Texas STEMI Workshop 

Data Registry Panel:NCTTRAC Data Collection & Analysis

Jennifer Gardner, RN

10/8/2014 ©2011, American Heart Association  2

Mission: Lifeline North Texas 

Faculty Disclosure Information

Jennifer Gardner, RNData Registry Panel: NCTTRAC Data Collection & Analysis

FINANCIAL DISCLOSURE:Employee of NCTTRAC

UNLABELED/UNAPPROVED USES DISCLOSURE: None

Jennifer GardnerNCTTRAC Clinical Informatics Manager

It started with the 1994 Texas Trauma System…

o Texas Administrative Code 157o Established 22 geographic Trauma Service Areas (TSA) o Established Regional Advisory Councils (RACs)o Identified essential components of required regional trauma 

planso Includes emergency preparedness

o Outlined trauma facility designation processo Established the Texas Trauma Registry to monitor the Trauma 

System and the incidence / costs of injury in Texas.

RAC Mission: support and improve all emergency healthcare through prevention,education, advocacy, research, preparedness, and response.

Reduce morbidity for 19‐counties around the Dallas FortWorth Metroplex, basically 27% of the population of Texas,via collaborative efforts with 167 hospitals, 32 of whichare designated trauma centers, and an estimated 200 EMS/Fireagencies, VFDs and First Responders.

Analyze data using historical data from REG*E the regional patientRegistry software solution for Trauma Service Area‐ E (TSA‐E).

TSA‐E Zones

NCTTRAC Zone VisitsZone 1  Sherman, Texas

Zone 2 Denton, Texas

Zone 3 Possum Kingdom, Texas

Zone 4 Ennis/Corsicana, Texas

Zone 5  Plano, Texas

Zone 6 Glen Rose, Texas

Zone 7  DFW Airport, Texas

Zone 8  Richardson/Rowlett, Texas

Data? Reports?

Seamless Integration

To locate Run Sheets for EMS agencies using Field Bridge

Hospital Hub

(for EMS agencies using ImageTrend’s Field Bridge)

Hospital Hub

Texas DSHS State Registry

REG*E

Regional Patient Registry

160Hospitals

151EMS/Fire

REG*E = 3 Million+ records

Standardized Call for Data

REG*E Q1 & Q2 2014

Standardized Reportsby Committee or Zone

Cardiac Committee Door to Primary PCI Door to Fibrinolytics

Stroke Committee Door to Needle (tPA)% of Door to CT

EMS Committee  FMC to door STEMI FMC to door Stroke FMC to EKG

Injury Prevention CommitteeMVA by Age by Zip

(Project: Just Drive)

SPI Committee Double Transfers 

Pediatric Committee Pedi X‐rays/CT scans/MRIs Pedi trauma ICU within one hour of identifying the need for ICU care.*

Trauma Committee Run Sheet status (PDCA) Patients 65+ Transfers (ISS >9) ED LOS Less Than 2 Hrs

Air‐Medical CommitteeAir‐Medical Services will be available for 

transport within sixty minutes.*

Zones # of Agencies Top Incident Types  Code STEMI Code Stroke

Golden Hour: STEMI Initial Reperfusion Treatment

Top Causes of Injury by AgeAll REG*E

Located in Patient Registry  >  Report Writer > Facility> Run Report Status

MOI by Trauma Type All REG*E for 2012 To 2013 To 2014 (current)

Located in Patient Registry  >  Report Writer > Incident Statistics > MOI By Trauma Type

Cases By Trauma TypeAll REG*E

located in Patient Registry  >  Report Writer > Sample > Cases By Trauma Type

Located in Patient Registry  >  Report Writer > Facility > Average Hours in ED by Facility and Calculated ISS ‐ Spline Chart

Average Hours in ED by ISS All REG*E

Project: DSHS CVD/RAC Survey‐ 52 out of 152 EMS agencies responded‐ TSA‐E has Regional Cardiac System Plan in place‐ 100% of EMS agencies at least 50% of units with 12‐lead capability‐ 81‐99% of agencies have at least 50% of staff Advanced Cardiovascular Life

Support (ACLS) trained‐ 81‐99% of agencies have destination protocols to determine where STEMI

patients are transported‐ 81‐99% of agencies perform pre‐hospital cath lab activation‐ 50% of hospitals provide STEMI patient outcome feedback to EMS‐ 50% of EMS agencies report First Medical Contact (FMC) to REG*E‐ 0‐20% of EMS agencies perform pre‐hospital fibrinolytics‐ 1 instance of cardiac data import in REG*E‐ Need STEMI multidisciplinary team or committee that routinely meets toevaluate STEMI performance and make improvement recommendations

Project: DSHS CVD/RAC Survey

Project: DSHS CVD/RAC Survey

• "lack of difficult getting date for stemi vs. other cx"; • "none in the diagnosis field";• "Due to time restrictions, unable to compile at this time"; • "can't compile this information";• "We do not do transfers";• "This data is not tracked in our RMS ‐ Firehouse";• "Chest pain/discomfort was all information available";• "Information not available";

Project: DSHS CVD/RAC Survey

PSAP to Door STEMI:incidents where the cath team was activated

PSAP to Door Stroke:Specialty Team Notification with CVA/Stroke as Primary Impression

Ensure process and submission support reporting

REG*E Stroke & STEMI Reports

FY 15 EMS Allotment/Allocation 911/3588 Monies

Criteria to meet NCTTRAC participation requirements:

Beginning January 1, 2016

EMS/Fire REG*E Data Submission

• Manual data entry

• Import NHTSA/NISE file NEMSIS file DSHS State of Texas file

• Web based service agreement or application program interface (API)

(ePCR vendor interfaces with REG*E and information passes without human interaction)

Who Benefits from Data?

Texas EMS/ Trauma 

Healthcare System of Region TSA‐E

REG*E Road MapEOY 2014 and 2015 and Beyond….

Annual Static Benchmarking Reports 

Regional Standard for ePCR Run Sheet Handoff 

Web Based Agreements w/ePCRs and REG*E 

Interface between DSHS State Registry and REG*E 

Closed Feedback Loop w/outcome PI data for EMS

Enhanced Cardiac and Stroke Reports

NCTTRAC Informatics SOP 

Community Forum for knowledge sharing

REG*E Regional Patient Registry

REG*E Road MapEOY 2014 and 2015 and Beyond….

Data Submission• Please send suggestions or current 

challengesReports as Tools• If you collect it, a report can be generated• If you have report challenges, please send them my way

Contact Jennifer Gardner at jgardner@ncttrac.org

“The two most powerful warriors are patience and time.”

Support Website• Knowledge Base: for User Help Manual guides• News: for REG*E system updates and outages• Tickets: help desk support and SPI referrals• Community: for open forum discussions

http://support.ncttrac.org

Questions? Advice?