New trauma registry supports and improves patient care

Information Technology team swiftly devises in-house solution to software challenge

Story by Leah Morrison

'If it ain’t broke, don’t fix it.' This popular saying could have easily applied to the province’s trauma registry in early 2024. Designed to track injuries, treatment plans, and patient outcomes, the registry plays a crucial role in improving patient care.

While the system itself didn’t require fixing, the unexpected need for a full replacement came as a shock for Alberta Health Services (AHS) Information Technology (IT) teams. They learned the software supporting the registry was being discontinued, leaving them just months to find a replacement before the end of the year. The 10 sites across the province who rely on the registry for operational and quality reporting we’re counting on the IT team to come up with something — and losing the registry was not an option.

The first step, according to IT domain architect Jeremy Fidelack, was to assess potential replacement options.

"From an IT architecture perspective, we always try to lay out what are the options for any potential solutions," he says, "to understand what the use cases are, what the problem is and what we could potentially do."

The IT team explored various solutions, including new products from the existing vendor, alternative third-party systems, or developing a product in-house. Ultimately, building a new registry internally emerged as the least risky option.

"All the potential solutions came with significant risks, but developing an in-house application was the most manageable," says Fidelack. "We had an established framework for building applications, so as long as we had the right people and resources in place, we knew we could make it work."

Fortunately, the IT team had strong partners on the trauma services team.

"This project was incredibly collaborative — more so than any other we’ve worked on," says Erin Bugbee, manager of Trauma Services & PCU 44 Trauma/Surgery at Foothills Medical Centre. "The relationship between stakeholders and the IT team was phenomenal."

IT worked closely with trauma services to ensure the new registry met all operational needs. While the data entry process remained the same to maintain consistency, the new system was modernized, more intuitive, and customizable as an internally built solution.

Beyond tracking patient data, the trauma registry serves as a critical tool for monitoring and improving care quality. Real-time data access enables trauma teams across Alberta to support research initiatives and make informed decisions that directly impact patient care.

For example, by reviewing data in the trauma registry, one trauma site was able to determine that during and post COVID-19 pandemic there was a significant increase in the number of patients that developed pressure injuries during their hospital stay. In response, a multidisciplinary pressure injury working group — including representatives from trauma teams, inpatient units, ICUs, and data analysts — was formed to assess prevention strategies and identify areas for improvement.

"Through the working group, we’ve significantly reduced pressure injury numbers over the past year,” says Claire Ewatski, data analyst. “It’s been a great example of how trauma registry data can drive meaningful changes in patient care.”

Similarly, the registry helped trauma teams at another site identify an unusually high number of ventilator-associated pneumonia (VAP) cases.

"We weren’t sure if the issue stemmed from how we were collecting data or if there was a clinical factor causing an increase in VAP cases," says AHS data analyst Alma Rados.

Rados collaborated with the trauma coordinator and fellow data analysts to review the data, ultimately determining there was a discrepancy in how the data was collected. Staff had been documenting VAP in patient charts whenever it was mentioned — even as a possibility or risk — regardless of whether the patient met the official clinical definition outlined by the Centers for Disease Control and Prevention (CDC).

This review led to process improvements within the ICU. "The trauma coordinator conducted extensive education with trauma analysts and ICU colleagues to ensure staff properly understood the CDC’s definition of VAP and recorded cases correctly," Rados explains.

The successful redevelopment of Alberta’s trauma registry highlights the power of collaboration, innovation, and adaptability. Faced with an unexpected challenge, IT and trauma teams worked hand in hand to build a solution that not only maintained continuity in patient data tracking but also modernized processes, improved efficiency, and strengthened integration with Connect Care.

More than just a database, the registry remains a critical tool in advancing trauma care across the province. Its ability to support research, improve patient outcomes, and drive quality improvements ensures that Alberta Health Services continues to deliver the highest standard of care to trauma patients.

As real-time data continues to inform decision-making and shape best practices, the trauma registry stands as an essential foundation for both present and future advancements in patient care.

A more streamlined process to integrate Connect Care data into the new trauma registry was developed. Within the application, data analysts are able to import patients and on the next calendar day upwards of 50 data elements are pulled from Connect Care, saving analysts about 10 minutes per chart. Previously, this was done outside of the registry using spreadsheets, leading to inefficiencies and a high probability for errors.

"Our trauma registry plays a vital role in research and innovation at AHS and is used by teams across other teams as well," says Bugbee. "It helps establish best practices in trauma care and ultimately improves patient outcomes."