Utilizing E-coded data for nonfatal injury surveillance in the pediatric emergency department setting: A literature review and recommendations

OBJECTIVES: Injury surveillance in the pediatric emergency department (PED) has the potential to be an important part of program planning and clinical management. However, a lack of data has been identified as one of the critical limitations in the field of pediatric emergency services research. The aims of this article were to investigate how injury surveillance has been attempted in the PED and to develop an understanding of why E-coding has not met its full potential as an injury surveillance tool in this setting. METHODS: We conducted a literature review for E-coding in the PED as well as for injury surveillance more generally in the PED. PubMed, PubMed Central, Google Scholar, CINAHL, EMBASE, and Academic Search Elite were used. Inclusion criteria were applied for each search. RESULTS: Two reports on E-coding in the PED met the criteria and were reviewed. Five articles on PED injury surveillance were reviewed. The most common mechanism of surveillance was a review of emergency department logs (n = 4). The second most common mechanism of surveillance was a physician- administered questionnaire (n = 2). CONCLUSIONS: Two of the 5 injury surveillance articles collected injury data from questionnaires completed by physicians, which is not a long-term, sustainable approach to injury surveillance. An ideal injury surveillance system for the PED should be designed with at least 3 main elements: minimal economic and resource burden, substantial practical uses, and measures to ensure data quality.