Objectives: To assess an emergency department-based injury surveillance project (S-EDISP) in China using WHO evaluation guidelines. To identify problems and make suggestions for improvement.
Methods: According to the methods provided by the WHO injury surveillance guidelines, retrospective evaluation, process evaluation and system environment evaluations were implemented monthly from 1 April 2006 to 31 March 2007.
Results: Results were collected in the three categories provided by WHO. (1) Retrospective evaluation. The injury rate from all emergency department (ED) logs was 40.4%, with no significant difference between weekends and weekdays. The accuracy of S-EDISP (percentage of injuries reported by the project) was 53.7%, and the accuracy rate (percentage of injuries accurately coded) was 79.3%. The differences between weekdays and weekends were significant for the accuracy of S-EDISP (59.0% vs 49.0%, respectively; p<0.05) and the accuracy rate (75.1% vs 88.7%, respectively; p = 0.03). The predictive value of the system was 100%. (2) Process evaluation. 87.0% of surveillance forms were filled out, and the mean (SD) completion time was 29.5 (4.0) min. Rates of incompletion of the forms were 31.6%, 40.0%, 23.8% and 50.0%, respectively, for every 6 h from 00:00 onwards (p = 0.051). (3) System environment evaluation. The staff included doctors (45.8%), interns (20.8%) and students (29.2%). Most of the staff (87.5%) had completed the S-EDISP training, and 41.7% of them reported difficulties with injury surveillance.
Conclusions: The accuracy of S-EDISP and completeness of the forms require improvement. Full-time, professional staff should be hired for monitoring injuries in order to provide a better work environment. The problems identified and suggestions provided should be useful in developing a national injury surveillance system for China and other low-resource regions.