"Each day, 43 Canadians die from injuries, which are the single biggest killer of people aged one to 44, and every year, injuries lead to 3.5 million emergency department visits in Canada," says Carol Scrivener, an emergency department nurse at Royal University Hospital (RUH), citing data from Parachute, a national organization dedicated to preventing injuries and saving lives.
"At RUH, we see about 9,000 injuries per year, or 750 per month, and that's just RUH – it doesn't include any other hospital in the province," Scrivener adds.
Last year, RUH became the first hospital in Saskatchewan – and the 18th in the country – to join the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP).
"CHIRPP is an injury and poisoning surveillance system that collects and analyzes data on injuries to people who present to the emergency department," says Dr. Bruce Cload, director of the program at RUH and one of the individuals responsible for bringing it to the province. "It organizes local data for quality assurance work, provides access to a national database and allows research partnerships between the emergency departments across Saskatchewan."
The program began in 1990 and is administered by the Public Health Agency of Canada. Data collected includes injuries that are accidental (e.g., falls, motor vehicle collisions) and intentional (e.g., self-harm, assault). Illnesses (e.g., abdominal or chest pain) are not included.
The system for collecting data is straightforward: patients who present to the RUH emergency department with an injury are asked to complete a standardized form from the Public Health Agency of Canada that asks a series of questions, including what they were doing when the injury happened, what went wrong and where the injury occurred. If the patient is unable to complete the form themselves, a nurse or volunteer will fill it out on their behalf.
"There's a checkbox on the back to indicate who filled out the form, so we know if it was a patient or staff member," says Scrivener, one of two CHIRPP coordinators who spends 10 hours a week entering the information into the national database.
"One of the most important factors in delivering state of the art, family-centred care is to have accurate local statistics so you can continually receive feedback from the community regarding new care initiatives and unusual or alarming trends in health outcomes. Using CHIRPP data, we can respond to issues in a timely and efficient manner," says Dr. Ron Siemens, a pediatric emergency physician and researcher at RUH.
To date, RUH has collected 1,500 records, contributing to the more than 2.8 million that have been collected nationally over the past 27 years. But Scrivener anticipates that the number currently collected could be doubled as staff learns more about CHIRPP and how to incorporate it into their daily practice.
"We're still trying to figure out the best process for collecting data from patients, because nurses are so busy – we see on average 750 injuries a month, but at this point, we're not getting 100 per cent of the forms filled out," she says, adding that having student volunteers from the University of Saskatchewan's Health Sciences department hand out forms to patients is helping.
Although the team is still in the data collection phase, Scrivener says she hopes that once she and her team have enough data to begin analysis, the information generated will identify local trends that will contribute to injury prevention in the community and province even before patients get to the emergency department.
In the past, national CHIRPP data has been used to create guidelines on children's play spaces and equipment, to sound the alarm about concussion in hockey and other contact/collision sports, and to help inform the baby walker ban in Canada, among other initiatives.