ARKANSAS TRAUMA SYSTEM INJURY PREVENTION UPDATE MARY AITKEN MD
Transcript of ARKANSAS TRAUMA SYSTEM INJURY PREVENTION UPDATE MARY AITKEN MD
ARKANSAS TRAUMA SYSTEMARKANSAS TRAUMA SYSTEMINJURY PREVENTION INJURY PREVENTION UPDATEUPDATEMARY AITKEN MDMARY AITKEN MD
Statewide Injury Prevention ProgramStatewide Injury Prevention Program
MARY AITKEN, MDMARY AITKEN, MD
Arkansas Mortality RankingsArkansas Mortality RankingsIntent Ages Ranking
All intents All ages 10th
Unintentional All ages 11th
Unintentional Birth to 24 yrs. 3rd
Mechanism Ages Ranking
Motor vehicle All ages 5th
M t hi l Bi th t 24 3rdMotor vehicle Birth to 24 yrs. 3rd
Burns All ages 4th
Drowning All ages 6thDrowning All ages 6
Drowning 10 – 24 yrs. 3rd
Motorcycle All ages 2nd
Statewide Injury Prevention ProgramStatewide Injury Prevention Program
Source: Centers for Disease Control and Prevention, WISQARS
Components of Trauma SystemsComponents of Trauma Systems
Emergency Medical Services (Pre‐hospital) g y ( p )Designated Trauma Centers
Trauma Registry Trained and Available Medical Professionals (Hospital)
Rehabilitation Facilities Injury Prevention and Control ProgramsInjury Prevention and Control Programs
Statewide Injury Prevention ProgramStatewide Injury Prevention Program
Prevention Is a Good InvestmentPrevention Is a Good InvestmentPrevention Is a Good InvestmentPrevention Is a Good Investment
Intervention Cost per Unit Return on Investment*
Child Car Seat $52/seat $2,200
Booster Seat $35/seat $2,500
Child Bicycle Helmet $12/helmet $580
Voluntary ATV Helmet Use $150/helmet $570Voluntary ATV Helmet Use $150/helmet $570
*Return on investment is defined as the amount injury prevention interventions saved by preventingReturn on investment is defined as the amount injury prevention interventions saved by preventing injuries, including medical costs, work loss, and quality of life costs. Calculated at 2004 dollars
Source: Injury Prevention, What Works? 2010 Update. Children’s Safety Network, 2010. Available at: http://www.childrenssafetynetwork.org/publications_resources/PDF/data/InjuryPreventionWhatWorks.pdf
Statewide Injury Prevention ProgramStatewide Injury Prevention Program
System Requirements for Injury Prevention
Section VII.G: “Injury prevention in the home and
y q j y
j y pindustry, on the highway and athletic fields; standardfirst aid; problems confronting public, medicalprofession, and hospitals regarding optimal care for thep , p g g pinjured. Could be a collaborative effort by severalhospitals or the region.”
Ref: Arkansas State Board of Health “Rules and Regulations for Trauma Systems” Rev. 2002
Injury Prevention is a requirement for all designated h l k (l l d )
e a sas State oa d o ea t u es a d egu at o s o au a Syste s e 00
trauma hospitals in Arkansas (levels 1, 2, 3, and 4)
Statewide Injury Prevention ProgramStatewide Injury Prevention Program
Multiple Strategies:Multiple Strategies:Multiple Strategies: Multiple Strategies:
• EducationEducation
• Engineering/Environment
• Enactment/Enforcement
• Economics
• EvaluationEvaluation
Statewide Injury Prevention ProgramStatewide Injury Prevention Program
Statewide Injury Prevention Program (SIPP)Statewide Injury Prevention Program (SIPP)
h f h d l d
j y g ( )j y g ( )
The mission of the SIPP is to reduce injury mortality andmorbidity within Arkansas across the age span.
The SIPP will serve as a resource and technical assistancecenter, collaborating with the Trauma Regional AdvisoryCommittees and assisting hospitals EMS services andCommittees and assisting hospitals, EMS services, andHometown Health Coalitions within each Trauma ServiceRegion with the identification, implementation, and
ill f id b d i j tisurveillance of evidence‐based injury preventionstrategies.
Statewide Injury Prevention ProgramStatewide Injury Prevention Program
• Communities• Institutions• Capacity
• Communities• Institutions• Capacity
• Registry• Linked Data• State/Regional
• Registry• Linked Data• State/Regional STATEWIDE INJURY
PREVENTION PROGRAMp y
• Commitmentp y
• Commitmentg
analysisg
analysis PREVENTION PROGRAM
Surveillance NeedsAssessment
InterventionEvaluation
• Evidence-basedT il d
• Evidence-basedT il d
• ProcessO t
• ProcessO t • Tailored
• Sustainable• Technology
• Tailored• Sustainable• Technology
• Outcomes• Bidirectional• Outcomes• Bidirectional
Surveillance: Progress to DateSurveillance: Progress to Date
• Excellent working relationship andExcellent working relationship and communication with ADH established
• Review of mortality and hospitalization data at• Review of mortality and hospitalization data at the state, regional, and county level
M h i f i d• Mechanisms for ongoing data requests developed
Unintentional Injury Related Deaths in Arkansas by Injury Mechanism, 2007-2009, All Ages
Source: CDC WISQARS 11
Hospitalizations from Motor Vehicle CrashesAmong Arkansans By Trauma System Region, 2007-2009
Source: Arkansas Hospital Discharge Data System, Health Statistics Branch
Needs AssessmentNeeds AssessmentNeeds AssessmentNeeds Assessment
• Lead agency: Injury Prevention CenterLead agency: Injury Prevention Center
• Assess existing activitiesAssess existing activities– Community level: HHI, Civic and Service Groups– Institution level: Trauma Hospitals, EMSp ,
• Measure capacity and investment– BaselineBaseline – Training
• Strategic planning
Statewide Injury Prevention ProgramStatewide Injury Prevention Program
Strategic planning
Needs Assessment: ProgressNeeds Assessment: ProgressNeeds Assessment: ProgressNeeds Assessment: Progress
• Electronic survey conducted by students from theElectronic survey conducted by students from the Clinton School for Public Services during 2010‐2011 academic year
• Final report demonstrates: – Strong support for injury prevention initiatives
– Limited capacity in staffing and funding
d f– Need for training
– Need for technical assistance for evidence based program identification and implementation
Statewide Injury Prevention ProgramStatewide Injury Prevention Program
identification and implementation
SIPP ImplementationSIPP Implementation
• Located at Arkansas Children’s Hospital Injury• Located at Arkansas Children s Hospital Injury Prevention Center
Lif h t ti• Lifespan approach to prevention
• Staffing– SIPP Program Manager
– Professional education coordinator
– Content‐area coordinators (motor vehicle, recreational, intentional, and home safety)
– Administrative assistant
CommunicationCommunication
• TRAC Injury Prevention subcommittees formed• TRAC Injury Prevention subcommittees formed to identify priorities for interventions
Data reviewed with TRAC IP subcommittees– Data reviewed with TRAC IP subcommittees
– TRACs setting up plans and activities
N k• Networks– SIPP web presence and listserv development
– http://www.healthy.arkansas.gov/programsServices/injuryPreventionControl/Pages/default.aspx
Resource Development and Resource Development and DisseminationDisseminationDisseminationDissemination
• Analysts have identified• Analysts have identified broad range of resources
• Resource binder providedResource binder provided to trauma affiliates– Print ready fact sheets, y ,presentations, and contacts
– Order forms for full toolkits
• In progress:– Toolkits on specific topics
f
Statewide Injury Prevention ProgramStatewide Injury Prevention Program
– Training of trainers
Professional EducationProfessional Education
• Injury Prevention 101• Injury Prevention 101– Basic overview of injury prevention approach
Off d l l t t– Offered regularly across state
• Injury prevention education integrated into i i hexisting outreach programs
– PedsPLACE, EdsPLACE telemedicine programs
• Next steps:– Training of trainers on specific prevention strategies
– On‐line training
Injury Prevention 101Injury Prevention 101Injury Prevention 101Injury Prevention 101
• Injury Prevention (IP) 101 is a one day 8 hour class
Injury Prevention 101Injury Prevention 101• Injury Prevention (IP) 101 is a one day, 8-hour class
which provides an overview of the basics of the field ofinjury prevention and how to implement an injuryprevention program
• This class discusses where and how to access data,partnering with community groups and how to planpartnering with community groups, and how to plan,implement and evaluate evidence-based injuryprevention programs
• Classes are offered monthly across the state• CEUs are offered for ARNA, CHES, APCB, ADE and
EMS
archildrens.org uams.eduarpediatrics.org
EMS
COUNTIES HOSTING INJURY PREVENTION 101 COURSES
Carroll
Izard Sharp
Baxter
Stone
Lawrence
RandolphBenton
Mississippi
Marion
Fulton ClayBoone
Madison
Greene
Washington Newton SearcyC i h d
White
Stone
ConwayCrittenden
Independence
Jackson
FranklinCrawford Van BurenJohnson
PopeCleburne
Poinsett
S b tiCross
Logan
Craighead
Garland
Prairie
Monroe
Faulkner
Yell
WoodruffCrittendenSebastian Logan
St. FrancisPerry
Scott
Lee
Saline
PulaskiLonoke
Polk
SevierHoward
LincolnCl l d
Hot Spring Jefferson Arkansas
PhillipsMontgomery
Grant
PikeClark
Dallas
NORTH CENTRAL
NORTHEAST
SOUTHEAST
IP 101 CLASS COMPLETED
Calhoun
Bradley
Ouachita
LincolnClevelandDesha
Miller
Little River Hempstead NevadaDrew
SOUTHEAST
SOUTHWEST
ARKANSAS VALLEY
IP 101 CLASS SCHEDULED UnionColumbia
MillerChicotLafayette
Ashley NORTHWEST
CENTRAL
Capacity BuildingCapacity Building
• Core Injury and Violence Prevention GrantCore Injury and Violence Prevention Grant– CDC funded grant
Long term capacity building at ADH– Long term capacity building at ADH
– Four focus areas: • Motor Vehicle Safety• Motor Vehicle Safety
• Unintentional Poisoning
• SuicideSuicide
• Concussion
– Other key areas: Falls, Violence, othersy , ,
– Injury Community Planning Group formed
Capacity BuildingCapacity Building
• Ongoing assessment of capacityOngoing assessment of capacity– Safe States STAT visit August 2011
Participation in TRAC meetings and IP– Participation in TRAC meetings and IP Subcommittees
• Resources for ADH staff statewide to engage in• Resources for ADH staff statewide to engage in injury prevention activities
T i i f HHI t ff– Training for HHI staff
– Integration of HHI and TRACs
Technical AssistanceTechnical Assistance
• SIPP will assists partners withSIPP will assists partners with– Data review and analysis
Identification of community partners– Identification of community partners
– Identification of evidence‐based interventions
P i l t ti d t i bilit– Program implementation and sustainability
• Next steps:– Pilot funding mechanisms
– Statewide motor vehicle intervention
– Pilot local and regional interventions
HHI
Trauma Hospital/EMS
Agency
Funding from multiple sourcesAgency sources
PreventionInitiative
Engagementngagement
• Universal– Use of standardized materials in clinical and community settings: Resource binder, toolkits
C i i i i i li b i– Communication: participate in listserv, website
• Statewide initiativesChild P S f t– Child Passenger Safety
– Training
• Regional and local initiatives• Regional and local initiatives– TRAC‐ and institution‐led based on local data
– Current activities: teen driving, ATV safety, child passengerCurrent activities: teen driving, ATV safety, child passenger safety, falls
SIPP TECHNICAL ASSISTANCE REQUESTS, b C t t A J l 1 2011 M h 31 2012by Content Area, July 1, 2011-March 31, 2012
archildrens.org uams.eduarpediatrics.org
SIPP STAFF TECHNICAL ASSISTANCE CONTACTS BY TRAC REGIONCONTACTS, BY TRAC REGION
archildrens.org uams.eduarpediatrics.org
SIPP CONTACTS BY COUNTYJuly 1, 2011 – March 31, 2012
Carroll
Izard Sharp
Baxter
Stone
Lawrence
RandolphBenton
Mississippi
Marion
Fulton ClayBoone
Madison
Greene
Washington Newton SearcyC i h d
White
Stone
ConwayCrittenden
Independence
Jackson
FranklinCrawford Van BurenJohnson
PopeCleburne
Poinsett
S b tiCross
Logan
Craighead
Garland
Prairie
Monroe
Faulkner
Yell
WoodruffCrittendenSebastian Logan
St. FrancisPerry
Scott
Lee
Saline
PulaskiLonoke
ShelbyTN
Polk
SevierHoward
LincolnCl l d
Hot Spring Jefferson Arkansas
PhillipsMontgomery
Grant
PikeClark
Dallas
Calhoun
Bradley
Ouachita
LincolnClevelandDesha
Miller
Little River Hempstead NevadaDrew
Counties assisted by the Statewide Injury Prevention Bowie
TX
UnionColumbia
MillerChicotLafayette
Ashley
j yProgram during the reporting cycle.
TX
ADH/Trauma System Statewide InitiativesADH/Trauma System Statewide Initiatives
In February 2012, the Arkansas Department of Health, Injury Prevention andIn February 2012, the Arkansas Department of Health, Injury Prevention and Control Branch issued a project application request to injury prevention partners within the Trauma Service Regions to submit proposals in two targeted areas:
1. Conduct Child Passenger Safety check-up events and distribute car seats to the community participants as needed.
2 E h T R i l Ad i l f f d t2. Each Trauma Regional Advisory may apply for funds to sponsor one individual to attend the 2012 Joint Annual meeting of the Safe States Alliance and the CDC Core Violence and Injury Prevention Program set for May 1-4, 2012 in Atlanta, Georgia.g y , , g
There were 29 requests for car seats for distribution and 3 requests forsponsorship to the Safe States/CDC Conference.
archildrens.org uams.eduarpediatrics.org
p p
Statewide Initiative:Child P S fChild Passenger Safety
• Goal: Improved child passenger safety
• Capacity: Child Passenger Safety Technician p y g ytraining targeting trauma affiliates
• Training infrastructure: Training sites in allTraining infrastructure: Training sites in all trauma regions (7 new sites)
• Access to equipment: Car seat distribution• Access to equipment: Car seat distribution throughout state to qualified sites
Statewide Injury Prevention ProgramStatewide Injury Prevention Program
Current Statewide Injury Prevention Initiatives
Carroll
Izard Sharp
Baxter
Stone
Lawrence
RandolphBenton
Mississippi
Marion
Fulton ClayBoone
Madison
Greene
Washington Newton SearcyC i h d
White
Stone
ConwayCrittenden
Independence
Jackson
FranklinCrawford Van BurenJohnson
PopeCleburne
Poinsett
S b tiCross
Logan
Craighead
Garland
Prairie
Monroe
Faulkner
Yell
WoodruffCrittendenSebastian Logan
St. FrancisPerry
Scott
LeeSaline
PulaskiLonoke
ShelbyTN
Polk
SevierHoward
LincolnCl l d
Hot Spring Jefferson Arkansas
PhillipsMontgomery
Grant
PikeClark
Dallas Counties receiving car seats
Calhoun
Bradley
Ouachita
LincolnClevelandDesha
Miller
Little River Hempstead NevadaDrew
Counties receiving car seatsfor Child Passenger Safetyevents.
Counties receiving fundingfor the Safe States/CDC
UnionColumbia
MillerChicotLafayette
Ashleytraining visit
Counties with facilitiesreceiving training equipment
Unintentional Injury Deaths, All Ages, 2000‐2009
50
60
40
per 1
00,000
20
30
Age
adjusted rate
United States
Arkansas
10
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Over last 10 years an average of 1300 Arkansans have died from unintentional
Source: WISQARS, Centers for Disease Control and Prevention
Over last 10 years an average of 1300 Arkansans have died from unintentionalinjury each year. This is 28% higher than the national average.
30
Motor Vehicle Related Deaths, All Ages, 2000‐2009
25
30
20
per 100,000
United States
Arkansas
10
15
Age
adjusted rate
5
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Source: WISQARS, Centers for Disease Control and Prevention
Over the last 10 years an average of 600 Arkansans have died from Motor Vehicle Related crashes. Although our death rate has dropped by 15% in the last ten years our death rate is still 40% higher than the US.
Motor Vehicle Related Deaths, Ages 0‐13, 2000 2009
8
9
2000‐2009
6
7
0 United States
4
5
e Ra
te per 100,00 United States
Arkansas
2
3
Crud
e
0
1
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Source: WISQARS, Centers for Disease Control and Prevention
45
50
Motor Vehicle Related Death, Ages 14‐19, 2000‐2009
35
40
45
United States
25
30
e Ra
te per 100,000
United States
Arkansas
10
15
20
Crud
e
0
5
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Source: WISQARS, Centers for Disease Control and Prevention
Seat Belt Use Arkansas and US: 2002 ‐ 2010
85%90%
78%
85%84%83%
82%81%82%80%79%80%
85%
se
70%70%69%68%
74%75%
70%
75%ARUSSe
at B
elt U
s
64%63% 62%
60%
65%
US
Perc
ent
S
AR Primary StopSeat Belt Law
55%
60%
2002 2003 2004 2005 2006 2007 2008 2009 2010
0%
2002 2003 2004 2005 2006 2007 2008 2009 2010Note: Seat Belt Law effective July 2009. NHTSA 2009 Seat Belt Survey done in AR July – Sept 2009Source: National Highway Traffic Safety Administration (NHTSA)
Slide courtesy of Gordon Reeve, ADH Epidemiology
Center for Applied Research and Evaluation1 Children’s Way, Slot 512-26Little Rock, Arkansas 72202-3591 Phone: 501-364-3400
SIPP Program CoordinatorGary Ragen, BSE, MEP, EMT-APhone: 501-364-3434Email: [email protected]
Home Safety Project AnalystReid Parnell, BAPhone: 501-364-3442Email: [email protected]
Professional Education CoordinatorRavina Daphtary, MAPhone: 501-364-3431Email: [email protected]
Recreational Safety Project AnalystLacye Vance, BS, ATCPhone: 501-364-3395Email: [email protected] I
Motor Vehicle Safety Project AnalystAmy Witherow, MPH, CHESPhone: 501-364-3443Email: [email protected]
Intentional Injury Project AnalystNichetra Magee, BAPhone: 501-364-3436Email: [email protected]