Optimising care in a Swiss University Emergency Department by implementing a multicentre trauma register (TARN): report on evaluation, costs and benefits of trauma registries

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Abstract
Background Diagnostic and therapeutic approaches to trauma patients are, depending on experience, equipment and different therapeutic doctrines, subject to wide variations. The ability to compare trauma centres using a standardised trauma register helps to reveal unresolved systemic issues and simplifies the quality management in an Emergency Department (ED). Methods This study describes the selection, implementation and initial evaluation process of an international trauma register in a level 1 ED in a university hospital. Furthermore, first preliminary results and a literature review on the benefits are presented. Results The UK-based Trauma and Research Network (TARN) was found to be the most suitable register for a level 1 Swiss trauma centre. In contrast to the majority of the mortality-oriented registry systems, the database is capable of predicting the probability of survival for the referenced patients. Staff and technical adaptations were arranged and regular and reliable data acquisition and entry was ensured within 6 weeks. The University Hospital Bern has performed well from the very beginning and ranks within the top ten hospitals. Conclusions With TARN, an appropriate trauma register has been chosen. First preliminary results have been obtained, and it was concluded that there was a good match between TARN's patient cohort and the Bernese. On the basis of the data entered into the register, the hospital authorities can now plan and perform improvements on the individual aspects of trauma care. Due to an objective comparability, weak points can be identified, lessons can be learned and further improvement can be achieved.

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