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Zara Quigg: Violence and TIIG Research Manager Centre for Public Health

Alcohol-related data collection in emergency departments: The Wirral model. Zara Quigg: Violence and TIIG Research Manager Centre for Public Health WHO Collaborating Centre for Violence Prevention. Objectives. Trauma and Injury Intelligence Group (TIIG) The Wirral Model

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Zara Quigg: Violence and TIIG Research Manager Centre for Public Health

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  1. Alcohol-related data collection in emergency departments: The Wirral model Zara Quigg: Violence and TIIG Research Manager Centre for Public Health WHO Collaborating Centre for Violence Prevention

  2. Objectives • Trauma and Injury Intelligence Group (TIIG) • The Wirral Model • Alcohol-related attendances • Reporting mechanisms • Interventions • Outcome • TIIG development across the North West

  3. TIIG • Funding: local partners • Injury surveillance system • Intentional / unintentional • Informing injury prevention strategies • Brings together a variety of data sources • Focus: ED data sharing Childhood injuries Falls Violence / alcohol 4/4 5/5 12/12 6/6 4/4

  4. ED data • Expansion of existing fields - Injury group: Fall / burns • Location: where in the home • e.g. Kitchen / stairs Existing data items • Injury group Assault, sports injury, RTC, self harm • Patient demographics Gender, age, area of residence • Date / time of attendance • Location of incident e.g. public place / home • Arrival / referral method • Disposal method (e.g. admitted) • Additional fields • Violence • Core • Time / date • Location assault (e.g. pub name) • Assault type (e.g. weapon used) • Enhanced • Relationship with attacker • Number of attackers • Gender of attackers • Reported to the police • Attacker consumed alcohol • Motive • Additional fields • Alcohol • Had you been drinking alcohol within three hours prior to the incident occurring? • Where did you consume / purchase your last drink?

  5. The Wirral Model • ED data collection 02/03 (baseline 03/04) • PCT / CSP strategies Figure 1: Proportion of injury attendances that are alcohol-related by year, Arrowe Park ED Target: reduce alcohol-related assault attendees by 15% over three years

  6. The Wirral Model Figure 2: Assault attendances by time and day of attendance, Arrowe Park ED 2008/09 • 40% of assault cases have been drinking • 74% between 2am and 4am weekend nights

  7. The Wirral Model Figure 3: Proportion of attendances to Arrowe Park ED identified as alcohol-related, under 18s only by age, Arrowe Park ED, 2007/08

  8. The Wirral Model • Two week alcohol audit • Electronic data collection identified 13 alcohol-related attendees (<18) • 1.6% of all attendees • Audit identified 5 • Female • Cider / Lambrini • Drank in street / park • Purchased from shop • 3/5 admitted to hospital Table 1: Alcohol-related attendances by demography, alcohol consumed, circumstances surrounding consumption and outcome, Arrowe Park ED

  9. Reporting

  10. Tackling Knives Action Programme (TKAP) project to Enhance Violence Prevention through ED Data Sharing [Wirral BCU (Arrowe Park data only)]

  11. Overview of ED Data [10/05/10 to 23/05/10]

  12. ‘Hot’ Locations in Reporting Period

  13. Violence occurs in Town and City Centres yet perpetrators and victims live elsewhere Reports Assault Presentation to Accident & Emergency by Deprivation of Residence

  14. Intervention • Development, implementation and monitoring of local alcohol and violence prevention strategies / prevention initiatives • Targeted policing and licensing enforcement • AMEC / TCVP / TKAP • Pubwatch • Best Bar None / Think 21 campaign • Targeted social marketing campaigns CCTV Licensing Street Lighting Alleygates

  15. England match days (EMD) • 33% increase assault attendances • Saturday / Thursday • 50% • No increase during World Cup period only (accounting for EMD) Prevention Event Planning

  16. Operation Xchange • Partnership approach • ED, police, primary care • 14th to 23rd Dec 2009 • ED data used to guide police operation • Targeted policing / licensing enforcement • Outcomes • 3 knives recovered • 21% reduction in wounding offences within the city centre • 57% reduction in ED assault attendances

  17. Prevention Marketing Campaigns

  18. Licensing Act and Alcohol Misuse Enforcement Campaign AMEC 2005/06 Rate of assault attendances/week 2002/03 2003/04 2004/05 2005/06 Financial Year Non-AMEC weeks AMEC weeks for 2005/06 Evaluation

  19. Arrowe Park, Wirral: 03/04 - 09/10 03/04 = 3,299 / 1,485 09/10 = 2,035 / 975 (38% / 34% reduction) Est. £40,800 saved (PCT) through reduction in ED alcohol-related assault attendances Est. £24,000 saved (provider) through reduction in alcohol-related assault admissions Trends

  20. North West data collection / sharing Number of EDs collecting and sharing alcohol and violence data with TIIG, by area

  21. www.tiig.info

  22. Contact details For and more information please contact: Zara Quigg, Violence and TIIG Research Manager 0151 231 4359, z.a.anderson@ljmu.ac.uk www.tiig.info Centre For Public Health Liverpool John Moores University WHO Collaborating Centre for Violence Prevention 5th Floor, Kingsway House, Hatton Garden, Liverpool, L3 2AY

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