F. Paruk1, I. Botchey1, A. Hyder1, K. Stevens2 1Johns Hopkins University Bloomberg School Of Public Health,International Health / Health Systems,Baltimore, MD, USA 2Johns Hopkins University School Of Medicine,Surgery,Baltimore, MD, USA
Introduction:
An assessment of Kenya’s trauma care capacity highlighted the need for a better understanding of the burden of injury and a need for standardized, quality trauma care training for clinical staff.
Trauma registries play an integral role in injury surveillance, identification of gaps in care, and in monitoring and evaluation of trauma care. Success in establishing and maintaining trauma registries is limited in low-resource settings. Efforts are being made to establish hospital based trauma registries at multiple sites in Kenya. Challenges include: lack of clinical skills necessary for trauma care, missing data, errors in transcription, backlog of data entry, and lack of reliable software for data management and export.
We aimed To educate clinical staff in trauma care skills while piloting a new mHealth injury surveillance tool. Goals were to successfully train hospital staff to care for the injured, improve data quality, reduce feedback time, enable data sharing, identify immediate gaps in care, and improve efficiency of the entire process. The data ultimately would highlight areas for immediate and long-term improvements in trauma care.
An educational curriculum including trauma skills and injury surveillance skills was developed and implemented at 4 hospitals in Kenya in 2013 and 2014. Using a free app-based program, a paper surveillance tool was adapted for mobile devices, and designed for real-time upload to a web-based database upon completion of each entry.
Methods:
Existing trauma care clinical skills and data collection methods in the Kenyan setting were assessed through literature review, focus group discussions, and site-visits. Data collection software for trauma registry data was selected, taking into consideration cost, ease of programming, functionality and feedback to the end-user.
Data is analyzed at regular intervals and feedback given to hospitals.
Results:
Preliminary results of the training program demonstrated improvement in data quality: missing and erroneous data was decreased upon implementation of training and mobile data collection, and adherence to trauma care protocols has improved. Vitals signs recorded on trauma patients at one site went from 29% pre-electronic data collection to 98%. Feedback from end users was positive, with increased efficiency of the process from data collection to analysis.
Conclusion:
In addition to expected outcomes, the use of mobile technology has decreased human resource requirements, while increasing interest and awareness for the program. Electronic data collection has expanded from one site to four sites over the past year with further potential to scale-up to the injury surveillance and standardize trauma training in Kenya.