Burn Centers use a burn registry software program to keep data on patients they have cared for. Many centers use a platform designed and supported by the ABA, which is available through a software development partner. Data from that registry may be transferred readily to the National Burn Repository (NBR) in response to an annual call for data. The NBR is also able to accept data that were originally entered on other platforms.
ABA Registry Software – Burn V 6 – Impact on Data Collection
- No impact – The following variables had no tangible change in data collection methodology between Burn V 6 and previous versions of the ABA Burn Registry Software: Gender, Age, Hospital Days, TBSA, hospital charges, and ventilator days
- Minor change – The following variables had minor mapping implications when merging Burn V 6 data with previously submitted data to the NBR: Race/Ethnicity, Etiology, Place of Occurrence, Circumstance of Injury, Hospital Disposition, and Primary Method of Payment. It is not expected that the required mapping tweaks created an inconsistent impact on the reporting.
- Major change – The list of options for Complications included in Burn V 6 was reduced to 39 complication types from 111 in Version 5. This reduction could conceivably impact the rates of complications when rates are reported in aggregate.
- Impact based on implementation of ICD-10 – The following fields are impacted by the inclusion of ICD-10 which is more a function of the point in time the data was collected, rather than the data collection method: Burn and Non-Burn Diagnosis, Place of Occurrence, MS-DRG, Procedures, and E-Code. Comorbidities and diagnosis related to admissions are additional fields that use ICD-10 in Version 6 but are not used in the creation of the Annual Report.
National Burn Repository (NBR)
The NBR is a database of patients treated at burn centers. It includes data elements that record the characteristics of the patients, description of the injuries and the mechanisms causing them. It also includes some data elements related to treatment and disposition after discharge. It has evolved over many decades. Approximately 90 U.S. Burn Centers contribute data to it every year. Several Canadian burn centers and a few international centers also submit data. The ABA publishes an annual summary report of the most recent 10 years of data.
The NBR is used as a basis for some epidemiologic studies, prevention programs, and advocacy for burn care. Annual submission of data to the NBR is required for Burn Center verification.
2017 NBR Report Key Findings
(data submitted between 2008 and 2017)
The Burn Quality Improvement Program (BQIP)
BQIP is a developing program within the ABA. It seeks to collect data from Burn Centers that describe various outcomes and complications in addition to data that reflect some of the processes of care, e.g. resuscitation fluid volume. Those data can be merged with patient data in the NBR to identify patient risk factors that are related to outcomes. Then the outcomes of the patients and thus the performance of a given burn center may be adjusted for the risk factors that apply to their particular patient population. The risk-adjusted performance of any given Burn Center can be compared or benchmarked with that from other centers and risk adjusted outcomes may be correlated with processes of care. The main purpose of BQIP is to demonstrate the variability in risk adjusted outcome between burn centers and so serve to stimulate Quality Improvement activities at individual burn centers and/or within self-identified groups of burn centers.
By: Palmer Q. Bessey, MD, FACS
Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY