Outdoor Medical Incident Database (OMID)

By Karim Haddad, Outward Bound Australia

In the last year, the Australian outdoor industry has seen insurance prices increasing by 40 to 2000 percent. How does an organisation demonstrate that risks are manageable when the public perception of the outdoors is all high-risk thrills and spills? The Outdoor Medical Incident Database (OMID) can assist this process as a tool that identifies preventable incidents and measures the effect of actions taken to reduce incidents.

OMID has been successfully used by Outward Bound Australia (OBA) over the last three years to actively reduce the number of medical incidents. In 1999 OBA had 6.25 incidents reported per 1000 participant days. This was reduced to 5.82 in 2000 and 4.23 in 2001, —an overall reduction of 32% in incident the frequency of incidents. (Over the same period the total number of participant days increased by 4 percent.) This reduction was done bythrough carefully analyzingsis of incident patterns and implementing changes in policy and practices. OBA uses four main phases in the implementation and use of OMID.

Phase Oone – : Collection ofng Ddata.

To begin with, a format needs to be established for the collection of data. A decision is made on what incidents are recorded – —those beyondover a certain degree of seriousness, or those involving lost program days, or some other suitable criteria. Procedures are established on when and how the incident is reported. Incident data is then entered over a period of time.

Phase Ttwo – : Identification oyingf Ppatterns

Once data has been entered, OMID can generate reports which look at incident patterns. These patterns answer questions like: Which activities have a higher incident rate? What kinds of injuries are happening? Are locations a factor? Or time of day? What is the primary cause of the incident? What role do pre-existing conditions play in the incidents?

When OBA first looked at the data in 1999, one of the strongest patterns was that 57% percent of incidents had involved a pre-existing health or fitness condition that contributed to the incident. Breaking this down further, iIt was then foundidentified that a large numberpart (40%) percent) of these pre-existing conditions had not been reportnotified to the instructor prior to the incidents. The majority of incidents in this category included were strains, sprains, muscle tears, and other musculo-skeletal injuries.

Phase Three: – Changinge Ppoliciesy or /Ppractices that Ccause Iincidents

After patterns appear in the incidents, an investigation into which areas incidents may be preventable occurs. A particular piece of equipment may need to be changed, or an activity altered. Perhaps a proactive approach can reduce the chance of incidents happening.

With the information about pre-existing conditions, OBA changed it’s medical forms to include a specific question on sports injuries. In addition, participants were asked about sports injuries in their medical form review with the instructor on the first night of the program. Then, if someone indicated that they had had previous trouble with their ankles, the instructor could proactivelybe proactive and tape the ankle before a bushwalking expedition.

Phase Four - : Monitoring for Cchanges in Iincident Llevels and Eevaluatinge Cchanges in Ppoliciesy or/ Ppractices

After a practice/policy is changed, it is important to retest the new data to see if there is a measurable difference. If no change can be seen, then look for other factors. It is important to remember that preventable medical incidents are being targeted through this process. Not all accidents or incidents can be prevented through changes in policies, training and procedures, especially in the outdoors. Thus, we can only work to prevent and reduce injuries or near misses not eliminate them.

After changes to OBA’s medical forms and the approach to pre-existing conditions, especially musculo-skeletal conditions, a dramatic reduction in the number of incidents dropped dramatically was observed. Unreported pThe numbers of pre-existing conditions, that were not notified, dropped by 43 percent%, from 1999 to 2001. This compares to a decrease of 19 percent% in reportedknown pre-existing conditions and a decrease of 25% percent inof incidents involvingwith no pre-existing conditions, over the same period. In 1999 the total number of pre-existing musculo-skeletal incidents was sixty-seven67. This had dropped to forty-six46 incidents in 2001, a reduction of 31 percent%. All these percentages mean that less fewer people have experience a medical incident on a program.

Summary

These four phases work continually to reduce incidents. An oOverall statistical decreases is one measure of success; another measure is athe shift in staff attitude toward incidents. Ten years ago there was a strongOBA staff were reluctantce to report accidents and incidents, a fearing that it would reflected on their abilities of an instructor. Through By implementation implementing of OMID and using the its information to target ways of reducing incidents, staff can see the benefits of a system. It allows staffgain the opportunity to learn from a variety of incidents. This active learning culture is an important part of an effective risk management strategy.

Certainly using a system like OMID needs requires expending additional time and effort to enter and analyse the data, but if incidents can be reduced over time, thate time is well usedspent. Not only are participants safer, but there are fewer incidents to manage and less time lost from programs.

Outward Bound International Offer

Outward Bound International received generous gifts from the bBoard of dDirectors, Outward Bound Canada, and Outward Bound Hong Kong to initiate the distribution of OMID to member centers. Schools that are interested in receiving a copy of the database are encouraged to contact Ian Wade (ianwade@globalserve.net). It OMID will be distributed on CD and will include a run-time version of MicrosoftS Access, so that you do not need to have this software installed on your computer system. The computers running the system will need to have a Windows 98 or higher operating system. Finally, iIf it is possible for your center to contribute towards the US$10,000 cost to OBI by purchasing a copy for US$500 (or whatever you can contribute), this willould help fully cover OBI’s costs.

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OMID – What is it?

The Outdoor Medical Incident Database is a computer-based system, written using Microsoft Access and Windows.

Features include:

· Runtime version of MS Access

· Incident data entry and review

· Participant day data entry

· Built in reports – —iIncident summary graphs, incident summary – , date range, instructor incidents, program summary, and yearly summary.

· Data bBackup and, recovery

· Export function to central database for comprehensive reports

· Customisable lists

· Incident report form template, participant days collection sheet

· Upgrades for one1 year

New Version 1.5 released June 2002

Requires Windows 98, ME or XP or later version

For more information about receiving OMID, contact, Ian Wade at ianwade@globalserve.net