In common with many areas of medicine, there is an acceptance by clinical burn care teams that the collection and analysis of accumulative data about clinical cases is necessary to allow progress in several areas of service development and delivery. This is particularly important for injury prevention and the improvement of patient outcomes. Collection of such data must be standardised, as much as possible, if the results of any analysis are to be useful, rather than misleading.
The list of the historically available data sources and a brief indication of their respective limitations were considered in the National Burn Care Review (NBCR, March 2001 - available from the downloads page), which concluded that a full picture could not be achieved without creating a specific registry to collect detailed information about burn injury.
In 2004 the UK National Burn Care Group (NBCG) funded the creation of the UK.NBID, which included the creation of the iBID data collection system and the infrastructure to support it. In April 2005, the data collection and analysis began. The design of the iBID software was based on recording what happens clinically following burn injury and to extract from that service management information that can be used for many purposes.
Aims of iBID
To make available a large volume of detailed data about burn injuries severe enough to require treatment by specialised services, which will allow advances to be made in a number of areas:
- Service provision monitoring
- Quality Assurance
- Planning and modelling changes in service provision
- Service accreditation
- Audit and support of Clinical Governance
- Outcome assessment
- Epidemiological research
- Design of multi-centred clinical research
One of the major concerns of the database design was to ensure that sufficient information was requested to provide data for the intended uses, but to ensure that undue detail was not requested. This might reduce the risk of incomplete and inaccurate data collection.
It has been emphasised at all stages of development that the Burn Injury Database was not intended to be an electronic patient record (EPR), although clearly it could form the basis of such a development in the future. The database was intended to be a record of the injury and some aspects of the process of inpatient care, so as to give an indication of the quality and costs of care but also an indication of clinical outcome and in addition measure some process of care outcomes.
The guiding principles of the database design were to ensure that the data remained:
- Acceptable: as a dataset to all working in burn care
- Available: from records covering the whole care period
- Measurable: for every case presenting and being admitted
- Collectable: without undue effort
- Meaningful: with a minimum of confounding factors
- Stable: so as to be useful as a long term measure of care and to monitor prevention efforts
Multiple reports are generated for participating burn services and health care commissioners. A few of these reports are made available to the public.