Breaking the Cycle
Implementing hospital-based community violence intervention programs
During Wednesday’s James D. Mills, Jr. Memorial Lecture, Dr. Christopher Crowell gave best practices and lessons learned for developing and growing community violence intervention programs in the emergency department.
He described violent injury as a recurrent disease and presented recent data on violent crime and homicides. As he dug through the data, Dr. Crowell identified non-fatal firearm injuries as an important opportunity for prevention efforts. “What better place to intervene than the ED?” Dr. Crowell asked the attendees.
As he explained the best practices of current hospital-based violence intervention programs, he focused on four key elements:
- Taking a public-health approach to injury prevention by focusing on mitigating modifiable risk factors
- Identifying and seizing the teachable moment during the patient interaction
- Taking a long view that utilizes culturally competent case management
- Linking patients with risk reduction resources
When caring for patients in the ED, Dr. Crowell said, “It has to start with implementing a culture of trauma-informed care.” Clinicians need to keep in mind that the traumatic event is far more than just the injury; having compassion for potential psychologic wounds supports healthy recoveries and increases a patient’s willingness to participate in risk reduction steps.
“Set high bars,” Dr. Crowell said. “Low expectations are going to yield modest results.”
He explained the importance of taking a long-term approach to community violence intervention that empowers patients to reduce their risk after they leave the ED. The problem of community violence is too complicated to expect quick results, but established programs show the potential positive impact of hospital-based efforts to mitigate community violence. Dr. Crowell reminded the audience: “It’s an intervention program, not an interruption program.”
For those who want to learn more about hospital-based violence intervention programs, Dr. Crowell recommended the Health Alliance for Violence Intervention as an invaluable resource that provides support and resources. The website provides handbooks and best practices from 45 other programs for to help new intervention programs get started.
