NHS Wakefield

Graphs

October 2011

A joined-up approach to getting better intelligence on childhood accidents

Jane Stark teamed up with hospital consultants and information analysts to improve intelligence gathering on childhood injuries, to support the development of highly targeted accident prevention campaigns.

Jane works for NHS Wakefield as a health improvement practitioner specialist. As someone who works with joint strategic needs assessments (JSNAs), she knows that the data often lacks the level of detail that accident prevention specialists need to develop targeted and effective campaigns.

“If you don’t know what’s really happening in your patch, you can’t address specific needs,” explains Jane.

“I wanted to find ways to get more specific information about the causes of unintentional injuries, including uncovering what was hiding behind the childhood accidents categorised as ‘accidental exposure to other and unspecified factors.”

The approach

Improving the analysis and reporting of data

Jane is part of a working group on accident prevention which brings together A&E consultants, hospital paediatricians, health visitors, nursery nurses and staff from children’s centres. The group meets four times a year, with separate meetings covering the needs of 0–5 year olds and 5-19 year olds. Jane wanted data to become a regular agenda item for these meetings, so with the group’s agreement, she invited the hospital’s information analyst to become part of the working group.

Each meeting now starts with a discussion of the latest data and emerging trends. Everyone has a chance to share their thoughts on what the data means for their area of work. In Jane’s experience, some people engage with data more readily than others, so she finds it helps to vary the way in which you present data by using visual tools such as maps and charts as well as presenting the raw numbers.

One of the first issues highlighted was around data coding. Jane met with the team responsible for assigning codes to patient’s medical notes and talked them through the accident prevention strategy and action plan. “I wanted to show the coders how essential their work is in developing effective prevention programmes,” comments Jane. “Seeing the genuine value of their coding work left them much more motivated to use specific codes and only use ‘other unintentional injuries’ as a last resort.”

At the same time, Jane talked to hospital doctors about the importance of providing as much detail as possible in medical notes, so that the coding team have enough information to work with.

Developing targeted programmes

Members of the working group became concerned about the number of 5–11 year olds having serious falls from playground equipment. On looking closer at the data, they found that the level of this kind of injury in one particular street was three times higher than for any other postcode. They turned to Google Maps to see if they could find anything unusual about this street and saw that every garden had a trampoline.

This insight led to a summer 2011 campaign to promote the safe use of trampolines at home. The programme involved free trampolining lessons and activity sheets for children, an awareness campaign in the local newspaper and an information sheet for parents giving practical advice on how to keep children safe when trampolining.

Outcomes

Since August 2010 there’s been a large reduction in the number of accidents coded as ‘other unintentional injuries’. Since the start of 2010 there has been a marked improvement in the number of admissions coded as ‘accidental exposure to other and unspecified factors’. These have fallen from around 17 per cent of admissions per quarter to just 3 per cent of admissions in the most recent quarter.

“With the improvements to the data, we have seen a rise in some types of accidents, including ‘strikes, crushes and jams’,” comments Jane. “We don’t really understand this category at the moment, so we’ve asked a team of junior doctors to examine recent case notes to find out more about the specific kinds of injuries and their causes.”

Following on from the safe trampolining campaign, the council’s sports and healthy lifestyles team has appointed a community sports coach with responsibility for trampolining. The initial campaign has now developed into a three-year programme.

Other accident prevention programmes that Jane is involved in also have a direct link to data and intelligence discussed by the working group. For example, at one meeting the hospital paediatrician raised concerns about babies being placed on raised surfaces, having seen a bad accident where a baby fell from a table while in a moulded foam seat. This led to an education campaign that helps health visitors and children’s centre staff to raise awareness of the dangers of placing babies in equipment on raised surfaces.

What we can learn

  • Find ways to help data analysts and hospital consultants understand why good data is important. Invest time in taking people through your accident prevention strategy and action plan.
  • Help everyone you work with to engage with data by presenting it in different formats, such as maps, and by including anecdotal evidence as stories too.
  • Think creatively about how you can build intelligence around specific data. Qualitative research and gathering anecdotal evidence can both help to build a fuller picture, as can Google Maps.
  • Provide regular feedback to people who provide you with data, to show them how you’ve used their input to develop targeted campaigns that have effectively reduced childhood accidents.

Further information

For more information about the work discussed in this case study, please contact Jane Stark on 01924 317766 or jane.stark@wdpct.nhs.uk

Related links

Updated February 2014