Pilot Implementation of a Multi-Site Injury Surveillance Registryin Haiti Open Access

Ingram, Martha-Conley E (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/1g05fb99n?locale=en


Background: Development of a trauma surveillance system has become a national priority for Haiti. In 2014, a trauma needs capacity assessment was conducted in 12 hospitals across 9 departments, as described in the WHO Guidelines for Essential Emergency and Surgical Care. Step two of the guidelines recommends development of standardized data-collection protocols, which allow for monitoring of disease burden and overall health outcomes. In this article, we present our pilot evaluation of implementing a new Injury Surveillance logbook with four Haitian Emergency Departments, specifically looking at the implementation within existing workflow processes and feasibility for tracking patients with trauma or injuries.

Methods: We designed a provider-based trauma and injury registry utilizing WHO Injury Surveillance Guidelines, existing trauma registries from other Low and Middle Income Countries, and with consideration for existing documentation systems in Haiti. The logbook was tested in four Haitian Emergency Departments for four weeks. Utility of the logbook was evaluated using quantitative indicators from WHO Injury Surveillance Guidelines (injury rate, recording score, completeness score, and accuracy score) and post-pilot survey responses from providers. Qualitative data was collected from users and was coded and analyzed using inductive methods.

Findings: Recording rates by staff ranged from 25% to 58%, and correlated with time of day, week of study, and hospital staffing at sites. Entry completeness rates ranged from 43-80%. The most frequently recorded variables pertained to mechanism (96%), location (95%), and type of injury (92%), as well as procedures performed (90%). Most commonly missed variables included vital signs (60%) and number of severe injuries (65%). Providers reported high agreeability with using the form (p<0.01). The most commonly cited barrier to using the form was 'lack of time'.

Interpretation: This format of an injury surveillance logbook was integrated into the natural workflow of patient care in Haitian Emergency Departments. The feasibility statistics demonstrate that there are areas in the tool that could be improved, but overwhelmingly there is support for the surveillance system to be used nationwide. Future steps include extending the trial period for an additional 6 months, and incorporating more facilities in surveillance of trauma.

Table of Contents







Tables and Figures

-Tables 1-3, Figures 1-8


About this Master's Thesis

Rights statement
  • Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.
  • English
Research Field
Committee Chair / Thesis Advisor
Partnering Agencies
Last modified

Primary PDF

Supplemental Files