In this issue

Hôpital de l'Enfant-Jésus pursues innovative projects

CHIRPP centres receive research funds

CHIRPP records reach half a million

Healthy Images at Health Canada

Nursing stations join program in Sioux Lookout

Nurses a IWK study behaviour and perceptions of risk

Kingston area group publishes injury profile

Recent CHIRPP reports available

The CHIRPP Sampler: Breakdown of cumulative CHIRPP data by selected variables

Welcome to CHIRPP News

Issue 7

March 1996

Hôpital de l'Enfant-Jésus pursues innovative projects

With each issue,CHIRPP News profiles one or more participating hospitals and their contribution to CHIRPP. In this issue, we take a look at Hôpital de l'Enfant-Jésus, one of the five general hospitals that are part of the program.

Hôpital de l'Enfant-Jésus (HEJ) is a 500-bed, 73-year-old general hospital in central Quebec City. In 1991, the team working at the public health unit (Département de santé communautaire) at HEJ became aware that, although injury was being recognized as a major health concern, little information on the circumstances surrounding injury was available. Team members needed more information on how, where, why and to whom injuries were occurring in order to set priorities and develop programs.

The Children's Hospital Injury Research and Prevention Program, as CHIRPP was then named, had begun collecting data a year earlier at 10 pediatric hospitals, but no similar surveillance program existed at general hospitals in Canada. Pierre Maurice, the Coordinator of the public health unit, approached Child Injury Section staff at the Laboratory Centre for Disease Control (LCDC) in Ottawa about the possibility of becoming part of the program. An agreement was made whereby the health unit could collect injury data using the CHIRPP form and software. At about the same time, the hospital foundation at HEJ provided funds to begin injury data collection.

Later that year, Child Injury Section staff decided to include some general hospitals in CHIRPP, and in April 1992 CHIRPP's name changed to the Canadian Hospitals Injury Reporting and Prevention Program. The program at HEJ became a full-fledged CHIRPP participant, providing CHIRPP with records on injuries to both adults and children and receiving funds from LCDC. About 21% of CHIRPP records now come from the general hospitals that participate in the program. About 13% of CHIRPP records are for injuries to adults.

The public health unit moved out of HEJ in 1993 when the entire provincial health system in Quebec was restructured. It amalgamated with two other public health units previously located in other hospitals to become the Quebec Public Health Centre. CHIRPP Director Pierre Maurice and CHIRPP Coordinator Jasline Flores now have their offices at that centre but continue to work closely with HEJ's emergency department. Ms. Flores visits the hospital at least twice a week to collect CHIRPP forms and to make sure the program is running smoothly.

In 1992, HEJ was designated as a tertiary trauma centre specializing in treating severely injured patients from all over eastern Quebec. Many severely injured people are transferred to HEJ every day. An important computerized trauma registry was developed to analyze the treatments and specialized services these kinds of patients need.

To make it easier to obtain injury information for the CHIRPP form from admitted patients, the CHIRPP centre made a video two years ago to be shown in the wards. It explains the importance of injury surveillance, and is now also shown on TV monitors throughout the hospital.

Some of HEJ's data collection activities differ from those of other CHIRPP centres. Data are collected in two places: the emergency room and the outpatient clinic. Patients with minor injuries report to the outpatient clinic and severely injured people report to the emergency department. And, the CHIRPP form is administered differently. Physicians combined the CHIRPP form and the emergency room form to save time. A new form was designed to duplicate the physician's notes, and Ms. Flores uses one of these copies to abstract the medical information needed for the CHIRPP form.

Another component of the HEJ program is the recent addition of the Centre hospitalier régional de Rimouski (CHRR) as a satellite CHIRPP centre. Rimouski is a city of 35,000 people located about 300 kilometres northeast of Quebec City along the St. Lawrence River. Dr. Maurice was interested in collecting data from a less urban area, and people at the health unit attached to the Rimouski hospital were eager to participate. In June 1994, the CHRR began collecting data using the CHIRPP form, with data analysis and program administration taking place at the Quebec City centre. André Dontigny, a physician with the health unit, is the CHIRPP Director and Geneviève Jomphe is the CHIRPP Coordinator.

The research, biostatistics and computer expertise at the public health unit at HEJ facilitated many uses of CHIRPP data from the beginning. People who were already working on injury prevention projects and research, in areas such as road safety, gun control and violence, had ready access to the data and many opportunities to use them. The calibre of injury research and intervention expertise at the Quebec Public Health Centre has been recently recognized internationally. In November 1995, the World Health Organization designated the centre's team, along with researchers at three other health units in Quebec (Montreal Centre, Bas St-Laurent and Monterégie) and the Public Health Division of the Ministry of Health, as an injury prevention "collaboration centre."

Dr. Maurice and Ms. Flores have responded to information requests from a wide variety of sources, such as other health units, hospital physicians, journalists, the Quebec sports safety board (Régie de la sécurité dans les sports du Québec (RSSQ), universities and local governments. Ms. Flores has produced, in cooperation with the other Quebec CHIRPP centres, occasional newsletters on different issues, such as baby walkers, trampolines and poisonings.

The most ambitious project undertaken by the CHIRPP team at HEJ is a recent profile of sports injuries seen at HEJ, commissioned by the RSSQ. Ms. Flores, who is also a Master of Science student in Epidemiology at Laval University, looked at CHIRPP records from July 1991 to June 1994.

Out of 19,100 injury records that CHIRPP collected at HEJ during the three-year period, 4,963 were sports-related. Using CHIRPP variables, she identified records on some 75 sports, and aggregated the data using Epi Info and Fox Pro computer software programs.

The final report profiles these injury records, with special sections on injuries related to the 17 sports for which there are the most records. The report for each sport includes tables showing the breakdown of injuries by month, time of day, age, sex, nature of injury and body part injured, and treatment. Additional charts show the circumstances of the injuries, depending on the sport.

The 150-page report is among the most detailed, comprehensive studies on sports injuries in Canada and is one of the largest research projects to use CHIRPP data.

Because the CHIRPP Director and Coordinator for HEJ are working in a public health unit, they are concerned with injury prevention interventions and are involved in a lot of mission-oriented research. At the health unit they have access to other databases, computer support and expertise, research and library materials, as well as the opportunity to work with other people involved in injury prevention. This situation explains why staff have made so much use of the data they collect. The recent sports injury report is an impressive example of what can be accomplished on the local level when resources, time and talent are available.

Most common sports injuries seen at HEJ

(Source: Portrait des consultations à l'Hôpital de l'Enfant-Jésus pour des traumatismes d'origine récréative ou sportive (TORS), de juillet 1991 à juin 1994)

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