O'Connor Kevin

In September 2004, Kingston, Frontenac and Lennox and Addington Public Health began a 2-year pilot project to develop and evaluate an Emergency Department Chief Complaint Syndromic Surveillance System in collaboration with the Ontario Ministry of Health and Long Term Care – Public Health Branch, Queen’s University, Public Health Agency of Canada, Kingston General Hospital and Hotel Dieu Hospital. At this time, the University of Pittsburgh’s Real-time Outbreak and Disease Surveillance (RODS, Version 3.0) was chosen as the surveillance tool best suited for the project and modifications were made to meet Canadian syndromic surveillance requirements. To evaluate the design and implementation of the system, a multi-sectored approach to evaluation was taken. Individual evaluations of the process, technical aspects and of cost/benefit were conducted to demonstrate proof of concept and the associated costs. An overall outcome or effectiveness evaluation will take place in spring 2006.

Objective

This paper outlines the approach used to evaluate an emergency department syndromic surveillance system on the following areas: process and outcome, cost/benefit and technical.

This paper describes a novel approach to the statistical classification of free-text chief complaints for the purpose of syndromic surveillance.

This paper outlines the integration of hospital admission, Febrile Respiratory Illness (FRI) screening and Canadian Triage and Acuity Score (CTAS) data streams within an Emergency Department Syndromic Surveillance system. These data elements allow better characterization of outbreak severity and enable more effective resource allocation within acute care settings.

In September 2004, Kingston, Frontenac and Lennox and Addington Public Health began a 2-year pilot project to develop and evaluate an Emergency Department Chief Complaint Syndromic Surveillance System in collaboration with the Ontario Ministry of Health and Long Term Care – Public Health Branch, Queen’s University, Public Health Agency of Canada, Kingston General Hospital and Hotel Dieu Hospital. At this time, the University of Pittsburgh’s Real-time Outbreak and Disease Surveillance (RODS, Version 3.0) was chosen as the surveillance tool best suited for the project and modifications were made to meet Canadian syndromic surveillance requirements.

Objective

This poster provides an overview of a RODS-based syndromic surveillance system as adapted for use at a Public Health unit in Kingston, Ontario Canada. The poster will provide a complete overview of the technical specifications, the capture, classification and management of the data streams, and the response protocols developed to respond to system alerts. It is hoped that the modifications described here, including the addition of unique data streams, will provide a benchmark for Canadian syndromic surveillance systems of the future.

Syndromic surveillance has been used been used as method of surveillance for various events in recent years. For example, post September 11th, 2001 anthrax attacks in New York City, World Youth Day in Toronto 2002, Salt Lake City 2002 Olympics, Democratic National Convention Boston 2004, and the G8 Summit in Scotland 2005.

Objective

Historical Emergency Department (ED) visits were examined to characterize ED utilization for the weeks before, during and after Queen’s University Homecoming weekend in Kingston, Ontario, Canada. This information was used to prospectively monitor the 2006 Homecoming period and inform key stakeholders.

A syndromic surveillance system has been implemented at Kingston, Frontenac and Lennox & Addington Public Health in Kingston Ontario as part of a pilot project funded by the Ontario Ministry of Health and Long-Term Care – Public Health Division. The information captured by the Real-time Outbreak and Disease Surveillance-based syndromic surveillance system includes Febrile Respiratory Illness screening results (implemented since SARS) for Emergency Department (ED) visits and information detailing hospital admissions.

Objective

To use an electronic real-time ED monitoring tool to involve public health, acute care and laboratory stakeholders in an integrated alerting and response process for community-wide influenza.

A retrospective chart review was performed to examine chief complaint, syndrome classification and discharge diagnoses of laboratory confirmed Salmonella Enteritidis phage type (PT) 13 cases who visited the Emergency Departments (ED) of two local hospitals during a province-wide outbreak in Ontario in the fall of 2005. This assessment was used to assess the sensitivity of the ED syn-dromic surveillance system to detect a local foodborne outbreak, and to modify syndrome classification.

To highlight the key role of Emergency Department syn-dromic surveillance in linking acute care and public health, thus enabling collaborative detection, monitoring and management of a local food borne outbreak.