Improving Trauma Data Quality in Rwanda: A Prospective Assessment of Registry Completeness and Accuracy

Background: High-quality trauma data are essential for data-informed decision-making. However, completeness and accuracy of trauma registries remain challenging in low- and middle-income countries. This study aimed to assess trauma registry data quality in Rwanda and describe a coordinated implementation package used to support improvements in registry completeness and accuracy. Methods: We conducted a prospective, longitudinal quasi-experimental quality-improvement study with repeated monthly measurements across eight hospitals in Rwanda from October 2023 to September 2025. Trauma registry data quality indicators-case missingness, variable missingness, and variable accuracy-were assessed monthly using a predefined Rwanda Trauma Registry data quality assessment and reporting protocol. Results: A total of 26,268 trauma cases were recorded across the eight hospitals. Linear mixed-effects models showed significant temporal improvements in trauma registry data quality. Case missingness decreased by 0.72 percentage points per month (β = -0.721; 95% CI -0.955 to -0.487; p < 0.001), and variable missingness declined by 0.33 percentage points per month (β = -0.331; 95% CI -0.435 to -0.228; p < 0.001). Variable accuracy increased by 0.25 percentage points per month (β = 0.253; 95% CI 0.198 to 0.307; p < 0.001). Conclusions: The findings show substantial improvements in registry completeness and accuracy during a coordinated, bundled, PDSA-guided quality-improvement implementation process in Rwanda. Because the study was uncontrolled and the activities were implemented together, the results should be interpreted as associations over time rather than causal effects of any individual intervention component.