First Wound Excision, Date and Time

Question: For Non-burn patients (ex. Hidradenitis patient) what should be selected for First wound Excision date and time?  The definition says first operative burn wound excision. Does this data element include non-burn cases first wound excision or does the bullet under additional information "select not applicable if no burn excision was performed" mean to select NA for non-burn cases? 

Answer: The "first wound excision date and time" field is for burn wound excision. For non-burn wounds, please select "Not applicable ".

Question: For non-burn patients, such as those with NSTI or non-healing wounds, is it necessary to complete the "first excision" section?

Answer: No. In the 2025 update to the Data Dictionary, we have added, “For non-burn wounds select not applicable”.

Hospital Discharge Date

Question: A question regarding two different cases where patients were admitted to inpatient hospice (with admit to Hospice order). The first case, the Burn Service continued to write notes each day while still managing their burns. The patient eventually died a couple of days later. The second case, the patient was admitted to inpatient hospice and died an hour later. The question is if the patient is under hospice care with an admit order would this end the encounter for abstracting in the registry even if we are still providing comfort care measures or do we continue the abstraction until the patient either discharges from the hospital or dies?

Answer: Yes, if the burn service has admitted, then transferred to hospice (in-pt hospice in the same hospital), consulted on a patient who is in hospice or consulted on a patient who is subsequently transferred to hospice, that patient should be tracked in the burn registry. So, if the patient was admitted to the Burn Service for treatment of a burn injury and then transferred to an inpatient hospice unit in the same facility, which seems to be the case for both patients, they will stay in the registry until they die in hospice care or are discharged from the hospital.
If you look at the Discharge Date in the 2024 Data Dictionary under Additional Information, it states:
The Discharge Date depends on the cause of other conditions that the patient has which require transfer to another service for care after treatment of the burn injury is completed (i.e. stroke, seizures, anoxic brain injury).

• If this condition is a result of the burn injury or its complications, then the hospital length of stay continues, and the discharge date is when the patient is discharged (or died) from the hospital.

• If this condition is unrelated to the burn injury or its complications, then the discharge date is the date the patient is transferred to the service taking over the care of the patient and enter for Discharge Disposition – Discharged/transferred to a Short-term General Hospital for Inpatient Care.

Total ICU Length of Stay

Question: A burn center only has ICU beds and med-surg beds. When there are intermediate care patients, they have to stay in an ICU room. Should the intermediate care days be counted as ICU days?

Answer: Yes, for the ABA Burn Registry all ICU and intermediate days are counted as ICU days.

Question: Can you clarify the Total Length of Stay - ICU days including a "step down” day?

Answer: The Total ICU Length of Stay is based on whatever your hospital calls an ICU Day including the step-down day. Stepdown days are a term for medical care, though the exact definition may change at different hospitals. The general definition is: “Stepdown beds provide an intermediate level of care for patients with requirements somewhere between that of the general ward and the intensive care unit.” Both ICU and Stepdown days are considered ICU days for the ABA’s purposes.

Total Ventilator Days

Question: For the "pneumonia, ventilator related" definition on page 121 of the Data Dictionary, the sourced material is to chapter 6 from the CDC National Healthcare Safety Network NHSN. Chapter 10 of the NHSN is the more updated source for this definition. Should we reference chapter 6 or chapter 10?

Answer: Please consult with your Infection Preventionist to determine what they recommend for reporting of Pneumonia, Ventilator Associated.  In general, NHSN Chapter 6, Pediatric Ventilator Associated Pneumonia (PVAP) and NHSN Chapter 10, Infection-Related Ventilator Associated Condition (IVAC) should be included.

Question: Is only pediatric ventilator related pneumonia (PVAP) counted as a complication or should Infection-related Ventilator-Associated Complication (IVAC), Ventilator Associated Condition (VAC), or Ventilator Associated Event (VAE) be counted as a Pneumonia, Ventilator Related?

Answer: Please consult with your Infection Preventionist to determine what they recommend for reporting of Pneumonia, Ventilator Associated.  In general, NHSN Chapter 6, Pediatric Ventilator Associated Pneumonia (PVAP) and NHSN Chapter 10, Infection-Related Ventilator Associated Condition (IVAC) should be included.

Question: Need clarification on what is considered wound closure at time of discharge.

Answer: The data point is intended to collect the percent of the wounds that are permanently closed at the time of discharge, either by re-epithelialization or grafting with a permanent wound coverage agent (STSG, FTSG, cell culture). 

Definition: Percent of the wounds, including the burns and grafted areas, that are healed at time of discharge.

Additional Info: Healed will refer to epithelialization of the wound bed. Estimate the percentage epithelialized with no further need for dressing intended to facilitate wound closure.

Hospital Discharge Disposition

Question: The hospital discharge disposition does not have an option to select discharged to an alternate residence such as foster care which would be a semi routine discharge in the instance of abuse. What discharge disposition is the appropriate choice?

Answer: In this case, you would select “Discharged/Transferred to court/law enforcement” as patients are not discharged to Foster Care without this being arranged by the courts when there is a question of abuse or investigation of abuse. 

Question: If a burn patient is admitted a 2nd time for planned operation and then discharged back to the rehab facility, would the discharge disposition be home or rehab??

Answer: If you are discharging to a rehab, then that’s what the disposition is. 

Question: What do you do when a patient has left the hospital against medical advice 4 times?

Answer: Record the admissions the way you normally would (Initial admission and Related admissions) and record for Discharge Disposition "Left Against Medical Advice or Discontinued Care." The decision to continue to admit the patient is up to your facility/burn service.

Question: A patient was homeless before admission and is being discharged to the street. Should we select "discharge to home or self-care" or "discharge to a shelter/half-way house/recoup care/street"?

Answer: Select Discharge to a shelter/ half-way house/recoup care/street, as this more accurately depicts where the patient was discharged to.

Percent Wound Closure at Time of Discharge

Question: For percent wound closure at time of discharge, occasionally an actual percentage is not given/known at time of discharge. Currently there is only a "not applicable" as an option. Is it possible to have not/know/not recorded option added here too?

Answer: No, you should discuss this with your clinical staff and obtain the best estimate for this and have them document this in the record.  If you can't obtain this, you should leave it blank.

Question: What should be recorded for "percent wound closure" when the patient dies?

Answer: Record the percent of the wound that was closed when the patient died. For example, if the patient had a 50% burn that was a quarter closed when they died, you would record 25%.

Question: If our providers do not document percent wound closure in their notes, what would be the appropriate way to report this in the BCQP registry? In the BCQP Case Entry Module the options are to report a percentage or report NA. NA does not seem appropriate since the data dictionary says to report for inhalation injuries only, but there is not an option for reporting not documented or not known/not recorded.

Answer: For documenting percent wound closure, if it is not documented in the medical record, it is suggested that you talk to your burn team members to get this information. If the data cannot be obtained, you will need to leave this field blank. Note that leaving the field blank will trigger an error message – please disregard the message and save the form.