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Public health
Original research
Implementation and initial analysis of Cardiff Model data collection procedures in a level I trauma adult emergency department
  1. Peter Nguyen1,
  2. Sara A Kohlbeck2,
  3. Michael Levas2,
  4. Jennifer Hernandez-Meier2,3
  1. 1School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  2. 2Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  3. 3Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  1. Correspondence to Dr Jennifer Hernandez-Meier; jhernandez{at}mcw.edu

Abstract

Objectives Our understanding of community violence is limited by incomplete information, which can potentially be resolved by collecting violence-related injury information through healthcare systems in tandem with prior data streams. This study assessed the feasibility of implementing Cardiff Model data collection procedures in the emergency department (ED) setting to improve multisystem data sharing capabilities and create more representative datasets.

Design Information collection fields were incorporated into the ED electronic health record (EHR), which gathered additional information from patients reporting assaultive injuries. ED nurses were surveyed to evaluate implementation and feasibility of information collection. Logistic regression was performed to determine associations between missing location information and patient demographic data.

Setting 60-bed academic level I trauma adult ED in a large Midwestern city.

Participants 2648 patients screened positive for assault injuries between 2017 and 2020. 198 patients were omitted due to age outside the range served by this ED. Unselected inclusion of 150 ED nurses was surveyed.

Main outcome measures Main outcomes include nursing staff survey responses and ORs for providing complete injury information across various patient demographics.

Results Most ED nurses believed that information collection aligned with the hospital’s mission (92%), wanted information collection to continue (88%), did not believe that information collection impacted their workflow (88%), and reported taking under 1 min to screen and document violence information (77%). 825 patients (31.2%) provided sufficient information for geospatial mapping. Likelihood of providing complete location information was significantly associated with patient gender, race, arrival means, accompaniment, trauma type and year.

Conclusions It is feasible to implement information collection procedures about location-based, assault-related injuries through the EHR in the adult ED setting. Nurses reported being receptive to collecting information. Analyses suggest patient-level and time variables impact information collection completeness. The geospatial information collected can greatly improve preexisting law enforcement and emergency medical systems datasets.

  • public health
  • qualitative research
  • organisation of health services

Data availability statement

Data may be obtained from a third party and are not publicly available. Data is not publicly available. Froedtert & the Medical College of Wisconsin health system should be contacted directly for data requests.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

http://dx.doi.org/10.1136/bmjopen-2021-052344

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    Data availability statement

    Data may be obtained from a third party and are not publicly available. Data is not publicly available. Froedtert & the Medical College of Wisconsin health system should be contacted directly for data requests.

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    Footnotes

    • Contributors PN contributed to the acquisition, statistical analysis, and interpretation of data and drafting the manuscript. SAK contributed to the study concept and design and acquisition of data. ML contributed to the study concept and design. JH-M served as the guarantor and contributed to the study concept and design, obtaining funding, and provided supervision of the study. All authors contributed revised the manuscript.

    • Funding This work was supported by the US Department of Justice National Institute of Justice and the Bureau of Justice Assistance, Office of Justice Programs grant numbers 2014-IJ-CX-0110, 2016-AJ-BX-K042, and 2018-AR-BX-K106.

    • Disclaimer The opinions, findings, and conclusions or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect those of the Department of Justice.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.