CHIRPP at the MCH · CHIRPP at Montreal Children’s Hospital Trauma Centre • From 1990-2010...
Transcript of CHIRPP at the MCH · CHIRPP at Montreal Children’s Hospital Trauma Centre • From 1990-2010...
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CHIRPP MCH, MCH Trauma, Public Health Agency of Canada 0
CHIRPP at the MCH
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CHIRPP at Montreal Children’s Hospital Trauma Centre
• Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP)is a computerized information system that collects and analyzes data on injuries to people (mainly children) who are seen at the emergency rooms of the 10 pediatric hospitals and of 4 general hospitals in Canada.
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CHIRPP at Montreal Children’s Hospital Trauma Centre
• CHIRPP is a unique, richly detailed database of "pre- event" injury information
• CHIRPP is a Canada-wide Program of the Injury & Maltreatment Section of the Health Surveillance and Epidemiology Division, Centre for Health Promotion, Public Health Agency of the Federal Government
• Each centre involved in CHIRPP has a designated Director & Coordinator
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CHIRPP at Montreal Children’s Hospital Trauma Centre
• From 1990-2010 CHIRPP functioned as somewhat of a silo program at the MCH
• Effective 2011, CHIRPP was integrated into the MCH Trauma System
• Closely linked to the MCH Trauma Centre’s Injury Prevention Program for research activities, development of educational materials, and injury prevention awareness campaigns
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Public Health Agency of Canada | Agence de la santé publique du Canada 4
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Public Health Agency of Canada | Agence de la santé publique du Canada 5
Canadian Hospital Injury Reporting & Prevention Program (CHIRPP)• Continuous data collection since 1990 – now 2 million records• Injuries treated in the Emergency Departments (EDs) • 11 paediatric EDs & 4 from general hospital EDs (all ages)• Data on injuries & circumstances – who, what, where, when how, why?• Evaluated in 1991, 2001Advantages• Timely • Complements population-based ICD coded data• National and local databases produced & used• Information on product & sport related injuries Limitations• Not reliable for intentional injuries• Under represents fatalities, rural, remote & Aboriginal populations
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Public Health Agency of Canada | Agence de la santé publique du Canada 6
CHIRPP Hospitals
* There currently are no past pediatric hospitals
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Why Focus on Injury?
• Injuries rank 4th among leading causes of death & hospitalization for Canadians
• Injuries result in premature deaths - leading cause of death for Canadians aged 1-44
• Economic costs of injury - $19.8 billion annually
• The major causes are well understood
• Injuries and maltreatment are predictable and preventable
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Public Health Agency of Canada | Agence de la santé publique du Canada 8
How CHIRPP is used• Response to queries from
– Other government departments– IP professionals– Media & others
• Large collaborative reports and reviews• Brief reports• Injury Surveillance On-Line • Data for researchers• Research 80+ published papers• Evidence supporting safety campaigns
– Safe Kids Week• Assessment of risks
– Product Safety Program, Health Canada; Transport Canada
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Public Health Agency of Canada | Agence de la santé publique du Canada 9
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Public Health Agency of Canada | Agence de la santé publique du Canada 10
Injury Surveillance
Ratio estimates 1 death: 15 hospital admissions: 400+ emergency department visits
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Public Health Agency of Canada | Agence de la santé publique du Canada 11
Successful Application of CHIRPP• Baby Walkers – banned in
Canada• Playground/play space – new
standards• Hockey – new rules for body
checking for children• ATV – new
legislation/regulation• Building codes – maximum
temperatures for hot tap water• Retail display hooks - redesign
and gradual replacement of hazardous single hooks
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Public Health Agency of Canada | Agence de la santé publique du Canada 12
Injury Surveillance
Baby Walkers• 1989 voluntary ban on the
sale of baby walkers
• CHIRPP shows that injuries continue
• Ban on sale and distribution 2004
• Appealed
• CHIRPP used in review
• Ban upheld 2007
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Public Health Agency of Canada | Agence de la santé publique du Canada, STATS CAN (1996,2001,2006) 13
MCH CHIRPP patients per 100,000 of the Montreal (0-17 yrs) population
aa
0.4 deaths
70 injury admissions
1,700 injuries
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Public Health Agency of Canada | Agence de la santé publique du Canada 14
Rates of CHIRPP visits per 100 MCH ED visits (all patients)
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Public Health Agency of Canada | Agence de la santé publique du Canada 15
Rates of CHIRPP patients per 1000 Montreal population (by age)
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Public Health Agency of Canada | Agence de la santé publique du Canada 16
Rates of CHIRPP patients per 1000 Montreal 0-17 yrs old population
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CHIRPP in the scientific Literature
• Over 90 articles using CHIRPP data have been published since 1992.
• Over 1,600 articles cited a CHIRPP article.
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CHIRPP in the scientific Literature
Protective equipment
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Public Health Agency of Canada | Agence de la santé publique du Canada 19
CHIRPP in the scientific Literature
Motor Vehicle Accidents
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CHIRPP in the scientific Literature
Evaluation
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Public Health Agency of Canada | Agence de la santé publique du Canada 21
CHIRPP in the scientific Literature
Socioeconomics
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CHIRPP in the scientific Literature
Sports
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CHIRPP in the scientific Literature
Patient recruitment
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CHIRPP in the scientific Literature
Sudden phenomenon
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Public Health Agency of Canada | Agence de la santé publique du Canada 25
CHIRPP in the scientific Literature
Epidemiology
Work-related injuries among children
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Annex – Injury Surveillance
Baby Walkers• 1989 voluntary ban on the sale of baby walkers
• CHIRPP shows that injuries continue
• Ban on sale and distribution 2004
• Appealed
• CHIRPP used in review
• Ban upheld 2007
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Public Health Agency of Canada | Agence de la santé publique du Canada 27
Things only I can tell you….
…injuries left and right
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Age
LEFT
Age
RIGHT
Injuries to the arm (shoulder to finger)
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RIGHT LEG57%
LEFT LEG43%
SOCCER
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RIGHT LEG54%
LEFT LEG46%
RUGBY
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RIGHT LEG55%
LEFT LEG45%
SKATEBOARDING
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RIGHT LEG46%
LEFT LEG54%
SNOWBOARDING
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RIGHT LEG44%
LEFT LEG56%
ROLLERBLADING
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RIGHT ARM53%
LEFT ARM47%
ROLLERBLADING
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RIGHT ARM45%
LEFT ARM55%
CYCLING
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RIGHT ARM44%
LEFT ARM56%
DOWNHILL SKIING
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RIGHT HAND84%
LEFT HAND16%
GOT MAD…. PUNCHED WALL, LOCKER