The Yorkhill CHIRPP story: a qualitative evaluation of 10 years of injury surveillance at a Scottish children's hospital.

BACKGROUND

The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) is an emergency department-based injury surveillance system that was devised in Canada and has been in operation since 1990. CHIRPP was imported to Glasgow's Royal Hospital for Sick Children at Yorkhill in 1996 and ran for 10 years.

OBJECTIVE

To critically review CHIRPP at Yorkhill (Y-CHIRPP). The following two key questions were posed. (1) Did Y-CHIRPP fail, and, if so, why? (2) What generalisable lessons can be learned about injury surveillance?

METHODS

A retrospective qualitative review of Y-CHIRPP was carried out. In gathering information, the aims were to: (a) describe the processes involved in running Y-CHIRPP; (b) identify changes made to that process over the 10 years; (c) determine the strengths and weaknesses of Y-CHIRPP.

RESULTS

Taken together, and with reference to the WHO attributes of a good surveillance system, the findings suggest that Y-CHIRPP largely met the criteria of simplicity, flexibility, and acceptability. Criteria that were not, or only intermittently, met were reliability, utility, sustainability, and timeliness.

CONCLUSIONS

Y-CHIRPP was, at best, a partial success. To maintain the viability of an injury surveillance system and to secure the long-term support of hospital staff, it is important that the system is perceived as an injury prevention service tool and not a research method. Experience with Y-CHIRPP suggests that injury surveillance requires three supporting posts: an emergency department staff member, a data analyst, and someone with responsibility for developing and/or lobbying for the implementation of preventive measures.