Subscribe to RSS
Neurotrauma Registry Implementation in Colombia: A Qualitative Assessment
Objectives Latin America is among several regions of the world that lacks robust data on injuries due to neurotrauma. This research project sought to investigate a multi-institution brain injury registry in Colombia, South America, by conducting a qualitative study to identify factors affecting the creation and implementation of a multi-institution TBI registry in Colombia before the establishment of the current registry.
Methods Key informant interviews and participant observation identified barriers and facilitators to the creation of a TBI registry at three health care institutions in this upper-middle-income country in South America.
Results The study identified barriers to implementation involving incomplete clinical data, limited resources, lack of information and technology (IT) support, time constraints, and difficulties with ethical approval. These barriers mirrored similar results from other studies of registry implementation in low- and middle-income countries (LMICs). Ease of use and integration of data collection into the clinical workflow, local support for the registry, personal motivation, and the potential future uses of the registry to improve care and guide research were identified as facilitators to implementation. Stakeholders identified local champions and support from the administration at each institution as essential to the success of the project.
Conclusion Barriers for implementation of a neurotrauma registry in Colombia include incomplete clinical data, limited resources and lack of IT support. Some factors for improving the implementation process include local support, personal motivation and potential uses of the registry data to improve care locally. Information from this study may help to guide future efforts to establish neurotrauma registries in Latin America and in LMICs.
16 June 2021 (online)
© 2021. Association for Helping Neurosurgical Sick People. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
- 1 Maas AIR, Menon DK, Adelson PD. et al. InTBIR Participants and Investigators. Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol 2017; 16 (12) 987-1048
- 2 Dewan MC, Rattani A, Gupta S. et al. Estimating the global incidence of traumatic brain injury. J Neurosurg 2018; DOI: 10.3171/2017.10.JNS17352.
- 3 Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet 1997; 349 (9061) 1269-1276
- 4 Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet 1997; 349 (9063) 1436-1442
- 5 Bonow RH, Barber J, Temkin NR. et al. The outcome of severe traumatic brain injury in Latin America. World Neurosurg 2017; 111: e82-e90
- 6 Hyder AA, Wunderlich CA, Puvanachandra P, Gururaj G, Kobusingye OC. The impact of traumatic brain injuries: a global perspective. NeuroRehabilitation 2007; 22 (05) 341-353
- 7 Carney N, Lujan S, Dikmen S. et al. Intracranial pressure monitoring in severe traumatic brain injury in latin america: process and methods for a multi-center randomized controlled trial. J Neurotrauma 2012; 29 (11) 2022-2029
- 8 Rubiano AM, Carney N, Chesnut R, Puyana JC. Global neurotrauma research challenges and opportunities. Nature 2015; 527 (7578) S193-S197
- 9 Bommakanti K, Feldhaus I, Motwani G, Dicker RA, Juillard C. Trauma registry implementation in low- and middle-income countries: challenges and opportunities. J Surg Res 2018; 223 (223) 72-86
- 10 St-Louis E, Paradis T, Landry T, Poenaru D. Factors contributing to successful trauma registry implementation in low- and middle-income countries: A systematic review. Injury 2018; 49 (12) 2100-2110
- 11 Kesinger MR, Nagy LR, Sequeira DJ, Charry JD, Puyana JC, Rubiano AM. A standardized trauma care protocol decreased in-hospital mortality of patients with severe traumatic brain injury at a teaching hospital in a middle-income country. Injury 2014; 45 (09) 1350-1354
- 12 Leavy MB. Multi-national registries: challenges and Opportunities. Accessed February 11, 2021 at https://effectivehealthcare.ahrq.gov/sites/default/files/pdf/multinational-registries-guide-3rd-ed-addendum-white-paper.pdf.
- 13 Patton MQ. Qualitative Research & Evaluation Methods: Integrating Theory and Practice. 4th ed. St. Paul, MN: SAGE Publications 2014
- 14 Takian A, Doshmangir L, Rashidian A. Implementing family physician programme in rural Iran: exploring the role of an existing primary health care network. Fam Pract 2013; 30 (05) 551-559
- 15 Assan A, Takian A, Aikins M, Akbarisari A. Challenges to achieving universal health coverage through community-based health planning and services delivery approach: a qualitative study in Ghana. BMJ Open 2019; 9 (02) e024845-e024845
- 16 Atkins L, Francis J, Islam R. et al. A guide to using the theoretical domains framework of behaviour change to investigate implementation problems. Implement Sci 2017; 12 (01) 77
- 17 Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci 2012; 7: 37
- 18 Fetterman DM. Ethnography: Step-by-Step. Vol. 17. 3rd ed. Los Angeles, CA: SAGE Publications 2009
- 19 Dasari M, Garbett M, Miller E, Machaín GM, Puyana JC. Implementation of a hospital electronic surgical registry in a lower-middle-income country. World J Surg 2016; 40 (12) 2840-2846
- 20 Mirbaha F, Shalviri G, Yazdizadeh B, Gholami K, Majdzadeh R. Perceived barriers to reporting adverse drug events in hospitals: a qualitative study using theoretical domains framework approach. Implement Sci 2015; 10: 110