TRAUMA REGISTRAR

Overview

It is important to acknowledge that high-quality data begin with high-quality data entry, and it is the trauma registrar who is responsible for performing this task. The Trauma Registrar is responsible for database management, conducting data analysis, and developing reports to communicate findings while maintaining a high level of confidentiality.

Responsibilities

• Identifies patients that meet criteria for entry into the trauma registry, utilizing the admission and discharge reports available.
• Responsible for entering all patients identified.
• Ensures accurate, thorough abstraction of data from the electronic medical record (EMR) into the trauma registry, in accordance with the current National Trauma Data Standard (NTDS) and New York State (NYS) Data Dictionaries, and Trauma Quality Improvement Program (TQIP) Process Measures.
• Maintains a concurrent trauma registry (80% of cases closed within 60 days of patient discharge) in accordance with current American College of Surgeons (ACS) requirements.
• Ensures any Ambulance Call Reports (ACRs) that are found to be incomplete in the EMR, are retrieved and sent to medical records for inclusion in the EMR.
• Enters findings from Medical Examiner Reports into the patient record, if and when the ME report becomes available.
• Performs inter-rater reliability (IRR)/data validation on 10% of all patient records. Specific data validation strategies will be determined by the Trauma Program Manager (TPM) and Trauma Performance Improvement Coordinator (TPIC).
• Ensures timely and accurate data submission to the New York State Trauma Registry, and Trauma Quality Improvement Program (TQIP), per each agency’s call for data.
• Runs trauma registry reports as requested by the TPM and Trauma Medical Director (TMD) in order to support the trauma Performance Improvement and Patient Safety (PIPS) program.
• Ensures that the trauma registry meets requirements for ACS designation.
• Ensures patient and hospital privacy and confidentiality are protected.
• Abide by facility HIPAA policies and procedures.
• Must attended two courses within 12 months of hire (if not already completed): 1) American Trauma Society Trauma Registrar Course; and,2) Association for the Advancement of Automotive Medicine (AAAM) Abbreviated Injury Scaling (AIS) Course (most current schema).
• Certified Specialist in Trauma Registry (CSTR) through the American Trauma Society’s Registrar Certification Board is desired upon hire. Must be obtained within 2 years of hire (if non-RN hire).
• Completion of a minimum of 8 hours of trauma registry-specific continuing education per year.

Qualifications

Education:

• Bachelor's degree required. Bachelors in healthcare or related field preferred.
• Must attended two courses within 12 months of hire (if not already completed):
• American Trauma Society Trauma Registrar Course; and,
• Association for the Advancement of Automotive Medicine (AAAM) Abbreviated Injury Scaling (AIS) Course (most current schema).
• Completion of a minimum of eight (8) hours of trauma registry-specific continuing education per year.

Experience:

• Previous experience as a Trauma Registrar preferred.
• Experience with medical terminology reguired.
• Experience with ICD-10 coding preferred.

Knowledge and Skills:

• Knowledge of anatomy and physiology required.
• Ability to fully utilize BHMC’s electronic record systems, equipment and other healthcare and billing systems relevant to this position.
• Ability to develop analysis and recommendations to business problems.
• Strong knowledge of excel and ability to use as an analytic and modeling tool.

Licenses, Certifications:

• NYS Registered Nurse preferred
• Certified Specialist in Trauma Registry (CSTR) through the American Trauma Society’s Registrar Certification Board is desired upon hire. Must be obtained within 2 years of hire (if non-RN hire).

Physical Requirements:

• Position requires prolonged periods of sitting and use of a computer and screen viewing throughout the working day.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The statements herein are intended to describe the general nature and level of work being performed by employees, and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of The Brookdale Hospital Medical Center.

BHMC is an equal opportunity employer, it is our policy to provide equal opportunity to all employees and applicants for employment without regard to race, color, religion, national origin, marital status, military status, age, gender, sexual orientation, disability or handicap or other characteristics protected by applicable federal, state, or local laws.