Canadian Trauma Data Standards:

Report and Recommendations

Produced by the Canadian Trauma Registry Data Standards Committee on behalf of the Trauma Association of Canada Performance Improvement Committee and Trauma Registry Information Specialists Committee

Endorsed by the Trauma Association of Canada Board of Directors on May 5th, 2025

Working group members: Jennifer McMillan, Deanna Fong, Claire Ewatski, Lynne Moore,

Fran Priestap, Allison Chisholm

TABLE OF CONTENTS

1. BACKGROUND ……………………………………………………………………………………………………….. 1

2. OBJECTIVE ……………………………………………………………………………………………………………. 2

3. APPROACH …………………………………………………………………………………………………………….. 2

4. CONSIDERATIONS ………………………………………………………………………………………………….. 3

4.1 The current situation …………………………………………………………………………………………………. 3

4.2 The goal of trauma registries in Canada moving forward ……………………………………………………. 4

5. KEY FINDINGS ……………………………………………………………………………………………………….. 5

5.1 Inclusion Criteria …………………………………………………………………………………………………….. 5

5.2 Data elements …………………………………………………………………………………………………………. 6

5.3 Data element definitions ……………………………………………………………………………………………. 8

6. RECOMMENDATIONS …………………………………………………………………………………………….. 9

6.1 Inclusion criteria ……………………………………………………………………………………………………. 9

6.2 Data elements ………………………………………………………………………………………………………… 9

6.3 Definitions…………………………………………………………………………………………………………….. 9

6.4 Data quality assurance…………………………………………………………………………………………….. 9

7. REFERENCES ……………………………………………………………………………………………………….. 13

8. ACRONYMS ………………………………………………………………………………………………………….. 13

1. BACKGROUND

The National Trauma Registry (NTR) was established by the Canadian Institute for Health Information (CIHI) in 1997 to equip health care providers, researchers, and injury prevention programs with essential information on trauma care in Canada. Data from the NTR also served to educate Canadians about trauma and its consequences. The NTR consisted of linked data from the Comprehensive Data Set (CDS) and the Minimum Data Set (MDS). The CDS was provided by Canadian trauma centers via provincial trauma registries that tracked patients hospitalized with severe injuries (Injury Severity Score [ISS]≥12). The MDS consisted of data extracted from the Discharge Abstract Database, and contained demographic, diagnostic, and procedural information on all acute care hospitalizations due to trauma in Canada. The NTR was discontinued on March 31, 2014, with CIHI citing several factors that influenced this decision including budget cuts and the fact that it was infrequently used.

A decade has passed since then and much has changed during that time. Clinicians, researchers, administrators, and other staff from Canadian trauma centers now regularly correspond and liaise with their peers across the country to improve the quality of trauma care. Membership with the Trauma Association of Canada (TAC) and participation in TAC sub-committees has played an integral role by providing the framework within which people can collaborate. The resounding theme across these interactions is sharing; sharing of information, solutions, ideas and strategies, and the cornerstone to all of these is the sharing of data.

The American College of Surgeons Committee on Trauma (ACS-COT) recognized the importance of trauma data collection to inform quality improvement and developed the National Trauma Data Bank (NTDB) in 1997. The NTDB is the world’s largest trauma data repository, used to guide quality improvement in participating hospitals and as a knowledge base for trauma research. This aggregation of data could not occur without the formation of the National Trauma Data Standard (NTDS), a standardized data collection system for trauma registries. The NTDS is a crucial component in developing nationwide trauma benchmarks, evaluating patient outcomes, facilitating research efforts, determining national trends in trauma care, addressing resources for disaster and domestic preparedness, and providing valuable information on other issues or areas of need related to trauma care in the United States3.

Although data from the NTDB has contributed to improving trauma care across the world, key differences between American and Canadian populations and healthcare systems do not often allow for meaningful comparisons of patient outcomes and processes of care. The time has come to consider new ways of collating Canadian trauma registry data into a national repository. The Canadian Trauma Data Standardization Project represents the first step in the creation of a common national trauma dataset that could be used to reduce injuries and related deaths in Canada, facilitate national and international comparisons of injuries, increase awareness of injury as a public health challenge and support trauma research in Canada.

2. OBJECTIVE

We aimed to emit recommendations to facilitate the standardized collection of trauma data across Canada.

3. APPROACH

First, we assembled a working group of trauma data specialists representing different Canadian provinces. Members are:

Jennifer McMillan (British Columbia)

Deanna Fong (British Columbia)

Claire Ewatski (Alberta)

Lynne Moore (Québec)

Fran Priestap (Ontario)

Allison Chisholm (New Brunswick)

The group met on six occasions between January 2024 and January 2025. At the first meeting, we identified working group objectives and themes to be covered. At following meetings, we worked on each of the following specific aims:

  1. Describe the purpose of trauma registries and identify reference documents
  2. Describe methods used for data collection in each province
  3. Explore the possibility of adopting/adapting an existing standard
  4. Identify a minimal set of data elements
  5. Identify additional data elements of interest
  6. Establish the source of data element definitions
  7. Identify caveats in line with vendors, heterogeneity in definitions, etc.

We then established a plan for the working group report and identified members responsible for each section. Preliminary results were presented at the 2024 TAC meeting in Halifax to members of TAC Performance Improvement Committee (TACPIC), Trauma Registry Information Specialists of Canada (TRISC), and Interdisciplinary Trauma Network of Canada (ITNC). The working group reconvened during the Fall of 2024 to finalize the report and emit recommendations. Early in 2025, the report was submitted to key partners across Canada to obtain feedback and after adjustments was presented to the TAC board of Directors. Recommendations will then be communicated to all TAC members.