Trauma Registrar

Trauma Registrar

The Trauma Registrar (TR) is an integral member of the Trauma Program and performance improvement initiatives. Under the direction of the Trauma Program Manager, the TR is responsible for extraction, collection, and coding, entry, and report generation of all data that is entered into the Trauma Registry as required by the State of Michigan, the National Trauma Data Bank, and the American College of Surgeons. The TR is tasked with concurrently extracting accurate and valid data of all trauma patients at Memorial Healthcare and ensuring that all records are completed within the mandated times set forth by the American College Of Surgeons. The TR maintains patient confidentiality at all times in compliance with hospital policy and State and Federal regulations. Strives for superior performance by consistently providing a product or service to leadership and staff that is recognized as ultimately contributing to the patient and family experience. Recognizes and demonstrates understanding of patient and family centered care.

Responsible To: Trauma Program Manager

Workers Supervised: None

Inter-Relationships: All Emergency Department staff, internal and external customers.

Primary Job Responsibilities

1. Performs concurrent and accurate data collection and entry into the Trauma Registry of patient demographics, injuries/illness, complications, physician response times, pre-hospital treatments, comorbidities, procedures, outcomes, and financial information of all trauma patients at Memorial Healthcare.
2. Participates in group and individual rounding on all in-house trauma patients and follows all trauma patients throughout their continuum of care to ensure concurrent and accurate data.
3. Ensures that all trauma patient data is entered into the appropriate registry within 60 days of patient discharge.
4. Analyzes patient data in order to properly code all patient diagnoses and procedures by using the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and Association for the Advancement of Automotive Medicine Abbreviated Injury Scale (AIS) guidelines.
5. Participates in quality assurance and improvement activities to ensure accuracy of data collection and timely submission of data according to state trauma registry and/or the American College of Surgeons.
6. Resolves routine coding issues/problems and appropriately seeks assistance from the Trauma Program Manager when needed.
7. Participates in internal and external community outreach and prevention projects.
8. Participates in, and provides data/reports for Performance Improvement and Patient Safety committee.
9. Generates reports and analyzes data at the request of the Trauma Program Manager and Trauma Medical Director, for use in Performance Improvement and Patient Safety committee meetings.
10. Identifies complications and areas for performance improvement in patient care and reports them promptly to the appropriate Manager.
11. Assists in the action planning and educational activities pertaining to trauma performance improvement.
12. Participates in continuing educational opportunities to maintain and expand trauma registry base knowledge and skill.
13. Provides registry analysis and reports at the request of hospital personnel and medical staff at the approval of the Trauma Program Manager and/or Trauma Medical Director.
14. Submits registry data to the National Trauma Data Bank and Image Trend as required by the American College of Surgeons and The State of Michigan.
15. Responsible for any additional duties assigned by the Trauma Program Manager within scope of ability and practice.

Departmental and Additional Job Responsibilities

1. Other duties as assigned.

Job Specifications

Education

1. Unencumbered license as registered nurse in Michigan is required.
2. Bachelor's Degree in Nursing is preferred.
3. AAAM-AIS Injury Severity Scoring certification is preferred.
4. American Trauma Society and/or Michigan Trauma Coalition Basic Trauma Registrar certification is preferred.

Experience

1. Two years of relatable healthcare experience is required.
2. Emergency Department nursing experience is preferred.
3. A high level of computer proficiency including advanced typing skills is required.
4. Medical coding experience is preferred.
5. Possess or be willing to gain expertise in ICD-10 coding, AIS coding, E-Codes and Injury Severity Scoring is required.
6. Previous experience and proficient working knowledge of Electronic Medical Records is required.
7. Data base registry experience is preferred.
8. Proficient knowledge of medical terminology and basic human anatomy is required.
9. Strong interpersonal skills are required.