Background

An existing occupational health database was the foundation for this project, motivated by the importance of surveillance of health care workers, and the opportunity to address the occupational health reporting requirements for pandemic influenza preparation.

Purpose

The purpose of our innovation project is to use routinely collected computerized occupational health visit data from Kingston General Hospital, in order to develop, implement and evaluate an innovative, real-time, early warning surveillance system, linked with an existing Emergency Department Syndromic Surveillance (EDSS) system. This project is the first in Ontario to conduct real-time surveillance of occupational health reporting with an infectious disease focus.

By monitoring respiratory and gastrointestinal illness activity within the community (EDSS) and hospital (occupational health) settings, the integrated system intends to provide enhanced early warning for communicable disease outbreaks, which may help to characterize the occurrence and transmission of infectious diseases and allow for increased infection control measures and implementation of emergency plans. Consequently, this information could be used to reduce health care worker absenteeism.

This project intends to provide early warning to key stakeholders, including the Occupational Health, Human Resources, Infection Control and Emergency departments of KGH, to enhance communication and collaboration for the purposes of rapid public health response.

Statistics

The occupational health data has been analyzed using the Centers for Disease Control and Prevention (CDC) Early Aberration Detection System (EARS). This tool uses cumulative sums of varying sensitivities to conduct statistical analysis of the data. Daily syndrome data is analyzed for statistical anomalies and compared to EDSS data, evidence of outbreaks as determined by public health investigation of institutional or long term care home (LTCH) outbreaks, and laboratory confirmed cases (eg. influenza).

Evaluation

As part of the funding agreement, a formal evaluation of the innovative real-time integrated OHSS system as a viable real-time surveillance tool took place. This evaluation was carried out using CDC’s ‘Framework for Evaluating Public Health Surveillance Systems for Early Detection of Outbreaks’ and the Public Health Agency of Canada’s ‘Framework and Tools for Evaluating Health Surveillance Systems’. The OHSS system continues to provide an ongoing data feed into a real-time dashboard of electronic information monitored by epidemiologists at KFL&A Public Health. It has proven to be an effective early warning system and situational awareness tool, and played an integral surveillance role in the H1N1 pandemic.

For more information on OHSS, an article detailing the system can be found here.