Injury location is a vital element and therefore scored accordingly. Location information such as geographic location and type of location along with where the patient was transported are one of the most important elements that meet the core requirements stated in the Code of Virginia related to mandated reporting to the trauma registry.
One of the core functions of the trauma registry was to assure compliance with trauma triage. Trauma triage assures that trauma patients reach definitive trauma care as prescribed in the State's trauma triage plan. Other core functions are measuring the incidence and severity of injury throughout the Commonwealth, and assist with the designation of trauma centers.
All hospitals in the Commonwealth began receiving information on the requirements that would be implemented beginning on January 1st, 2014 almost one year in advance. This allowed time for processes to be put in place to assure the information was collected. If patients are a walk-in patient this could be added to your ED nursing triage note or part of the registration process. If the patient arrives by EMS this information can be found on the EMS medical record. There may be better avenues within your facility.
Related to unknown versus unknown and if there is a difference. No there is not, they are both non-responsive answers. In many scenarios you can technically add a not-reported or unknown, but they will not meet quality standards. In the near future we will begin reporting average data quality scores to show your facility how you are doing. The measures build in a generous amount of flexibility for those instances where the data is unobtainable, but no flexibility for a pattern of not routinely reporting required information. In other words we do not look at the score of each and every record submitted but the average over a time period i.e. quarter. This will allow the needed flexibility when a piece of information cannot be obtained.
After a transition period, repeated poor data quality will transition to a compliance process. Please take advantage of this transition period to improve processes that help you meet submission requirements. We are available to provide technical assistance and answer questions that will help. If the information you need is EMS related (which is minimal for hospitals) we encourage you to work with your local EMS agency. We also have the means to provide access to some EMS data as we also collect EMS data on all EMS responses in the state, and if ultimately, there is an EMS compliance issue we can assist with that.