Give today to bring the USNWSAP to life and drive lasting change in drowning prevention.

DS 6 Support Use of Syndromic Surveillance to Identify Drowning Trends

Key area

Data Surveillance

Support the use of syndromic surveillance to identify emerging trends in drowning.

Spectrum level: Changing Organizational Practices

Evidence level: Low

Implementation levels: Community County State

Rationale:

Syndromic surveillance provides timely data for detecting, understanding, and monitoring health events using emergency department data (before diagnosis is confirmed). Syndromic data have been used in responses to other injury problems including opioid overdoses and e-cigarette or vaping product use and associated lung injury. Syndromic surveillance could be used to identify spikes in drowning cases and provide timely prevention action and prioritization of resources to mitigate the problem. Exploration of the usefulness of this data source for drowning is underway. Evaluation will be needed before impact can be estimated, however access to timely data on drowning has the potential to be highly impactful. This may provide a reasonable and timely means to monitor drowning by state and local organizations.

Anticipated Impact:

After implementing this recommendation, you can expect to experience the following outcomes. - Supporting the use of syndromic surveillance to identify emerging trends in drowning may be highly impactful as it may provides a reasonable and timely means to monitor drowning by state and local organizations.

Evidence:

Efforts around syndromic surveillance have proven helpful in providing timely data for action in other injury contexts such as suicide, opioid overdose and acute lung injury from vaping or e-cigarette use (CITE).

Evidence Sources:

Overview of Syndromic Surveillance: What is Syndromic Surveillance? https://www.cdc.gov/mmwr/preview/mmwrhtml/su5301a3.htm

Emergency department visits for suspected suicide attempts among persons aged 12-25 years before and during the COVID-19 Pandemic – United States, January 2019 – May 2021: https://www.cdc.gov/mmwr/volumes/70/wr/mm7024e1.htm

Development and Validation of a Syndrome Definition to Identify Suspected Nonfatal Heroin-Involved Overdoses Treated in Emergency Departments: https://journals.lww.com/jphmp/Fulltext/2021/07000/DevelopmentandValidationofa_Syndrome.5.aspx

High Risk Populations Addressed:

All populations can benefit from implementation of this recommendation.

Evaluation Metrics:

Indicators of long-term impact:

  • Standardized drowning definition for use with syndromic surveillance data is implemented
  • Evidence that syndromic surveillance data produces more timely estimates of drowning burden at the local, county, state, and/or national levels

Indicators of intermediate impact:

  • Infrastructure and training in place for use at local, county and state levels
  • The number of sites (e.g. hospital surveillance programs, state and local health departments) monitoring drowning using syndromic surveillance increases

Indicators of initial impact:

  • Validated drowning definition uploaded into National Syndromic Surveillance Program

Implementation:

Consider the following to ensure successful implementation:

  • Support continued development and validation of a standardized query (i.e., definition) for identifying drowning cases based on chief complaint and discharge diagnosis fields.
  • Test the utility of syndromic surveillance for identifying temporal and geographic surges in drowning as well as disparities among underrepresented minorities.
  • Standardize data collection across jurisdictions to allow compilation (drowning is a scientifically rare event) and comparison which is why development at a national level would be most helpful.
  • Involve the National Syndromic Surveillance Program (NSSP), State and Local Health Departments, and existing Hospital syndromic surveillance programs.
  • Review syndromic surveillance data, generally available to public health programs.
  • Provide support and training to assist local and state jurisdictions in appropriate use.

Challenges to Implementation:

When implementing this recommendation, you might encounter challenges related to the following factors.

  • Current evidence of the usefulness of syndromic surveillance for drowning at the local, county, and state levels may be limited.
  • Resources to provide training to implement may be lacking.
  • Infrastructure at the state, county, and local levels to implement and support may be limited.
  • Interest in monitoring drowning at the state, county, and local levels may be lacking due to competing priorities.

Potential Facilitators:

The following factors might facilitate the implementation of this recommendation.

  • Syndromic surveillance is well-established in all states.
  • Other injury prevention efforts have successfully used syndromic surveillance for suicide, opioid overdoses and acute lung injury from vaping and e-cigarette use.
  • Timeliness of drowning data collected by syndromic surveillance may assist local prevention programs.
  • Drowning may be well suited to ED & hospital based surveillance, such as syndromic surveillance, since the vast majority of drownings that are not immediately fatal will seek ED or hospital based care (as opposed to treatment in primary or urgent care facilities).
  • CDC has projects underway to validate the query.

GAP Recommendation:

None