Health Systems Interventions to Prevent Firearm Injuries and Death Proceedings of a Workshop (2019) / Chapter Skim
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9 Developing a Culture of Health Care Providers as Interveners
9 Developing a Culture of Health Care Providers as Interveners
Pages 85-96
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From page 85... ...
, the president of the Health Research Education Trust, a practicing internal medicine physician at the Erie Family Health Center (Chicago) , and a faculty member at both the Northwestern University Feinberg School of Medicine and the University of Michigan Medical School; Deborah Kuhls, a professor of surgery, trauma, and critical care and the program director of the surgical critical care fellowship program at the University of Nevada, Las Vegas, School of Medicine, and the chair of the American College of Surgeons Committee on Trauma Injury Prevention and Control; and Shannon Cosgrove, the director of health policy at Cure Violence.
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From page 86... ...
In March, the HAV initiative hosted a national convening of human trafficking experts to discuss health system inter entions to address this public health crisis and to continue to advise v and inform programs and educational offerings. Additionally, HAV and AHA's Coding Clinic, joined by experts from Catholic Health Initiatives and the Massachusetts General Hospital's Human Trafficking Initiative and Freedom Clinic, worked to develop International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10)
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From page 87... ...
Furthermore, predictive models and the use of clinical decision support can help engage clinicians inquire and potentially take action to prevent and reduce firearm injury. CONSENSUS-BASED FIREARM INJURY PREVENTION STRATEGY Across the United States, more than 500 trauma centers, verified by the American College of Surgeons, stand ready to treat the most seriously injured patients.
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From page 88... ...
Given how controversial and divisive the topic of firearms can be, the organization first surveyed its leaders in trauma surgery to find out their opinions on firearm injury prevention and advocacy; a survey of all 80,000 American College of Surgeons members was just completed and its results were being awaited at the time of the workshop. The initial survey, which received more than a 90 percent response rate, revealed that: • trauma surgeons felt that violence is the root cause and is a major problem in the United States, • reducing firearm injuries and deaths should be a top priority for the American College of Surgeons, • health care professionals should be allowed to talk with their p atients about how to prevent firearm injuries, • the federal government should fund research on firearm violence, and • the trauma community should partner with mental health to ddress a the mental health components of firearm injuries and death.
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From page 89... ...
With that as background, Cosgrove explained what Cure Violence does as an organization. Founded in 1999, Cure Violence was intended to replicate the World Health Organization's three-pronged approach to epidemic control, which involves interrupting transmission, working with those at highest risk to change behaviors, and changing community norms.
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From page 90... ...
Perhaps the most striking results have been in the city's Queensbridge Houses, the largest public housing development in the country comprising 96 buildings spread across 6 blocks, where there have been no shootings or homicides for more than 1,000 days. Cure Violence is not the only successful program for reducing gun violence using health approaches, Cosgrove said, but unfortunately these different programs are not working together to figure out how to integrate their work and create a comprehensive system for violence prevention.
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From page 91... ...
, who represents part of Chicago, Cosgrove and her colleagues designed H.R.2757, the Public Health Violence Prevention Act, which would amend the Public Service Health Act to establish a National Center for Violence Prevention and provide $1 billion to be invested in implementing health approaches in communities across the nation. Cosgrove explained that the hope is that this bill will be reintro uced after January 1, 2019.
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From page 92... ...
ENSURING AN EQUITY LENS Ensuring greater bene�it and less burden for marginalized communities by: • Changing perceptions PUBLIC HEALTH DEPARTMENTS • Increasing accountability SCHOOLS OF PUBLIC HEALTH & UNIVERSITIES HOSPITALS AS ANCHOR INSTITUTIONS • Aligning resources in partnership IN PARTNERSHIP WITH ELECTED OFFICIALS with communities Preparing Movement Leaders with Curricula and Research Ensuring Quality Care, Outreach and Follow Up Coordinating and Developing Interventions EMERGENCY DEPARTMENTS AND ACUTE CARE FACILITIES COMMUNITY Identifying and Supporting ORGANIZATIONS Individuals and Families at Risk SCHOOLS Holding Systems Accountable HEALTH CARE Creating Safe and Healthy Learning Environments and Providing Comprehensive Interventions SYSTEM Incorporating Violence MENTAL HEALTH Prevention in Economics and Policy Promote Accessibility for Greater Well-Being BEHAVIORAL HEALTH CARE COMMUNITY RESIDENTS Providing Trauma-Informed Services for Improved Outcomes Leading the Local Movement EARLY CHILDHOOD DEVELOPMENT CENTERS & THE CHILD WELFARE SYSTEM Addressing Trauma to Start Off Strong ACADEMIC MEDICAL CENTERS SOCIAL SERVICE PROVIDERS Advancing Research on Violence Prevention Utilizing Community-Centered Practices to Address Violence PRIMARY CARE COMMUNITY Establishing a Safe INFORMATION SYSTEMS LAW ENFORCEMENT AND THE JUSTICE SYSTEM MEDIA Environment and FAITH-BASED INSTITUTIONS Making Connections Monitoring Trends of Supporting Public Health Contributions and Ensuring Changing to Educating and Healing Communities Ellen Lovelidge (elovelidge.com) 2017 Violence Nationwide Accountability Towards a Healthy/Equitable System a Health Narrative FIGURE 9-1 A framework for creating a health system to prevent violence.
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From page 93... ...
Kuhls said that she sees trauma centers as a model that could be expanded nationwide with additional funding, noting that trauma centers exist nationwide and that they are required to partner with community organizations in injury prevention. One of the challenges is that there are what Kuhls called "trauma center deserts" throughout the country, but she noted that there are other health systems, such as the Veterans Health Administration (VHA)
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From page 94... ...
The challenge, Cosgrove said, is holding health systems accountable for using the community health needs assessments to implement violence intervention programs. She cited Louisville, Kentucky, as an example of a city doing just that in coordination with their health department.
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From page 95... ...
Joseph Richardson from the Capital Region Violence Intervention Program, an HVIP that has been running for more than 1 year and has served 116 participants, none of whom have returned to the emergency department, asked about the role that involvement with the criminal justice system plays as a risk factor for repeat violent injury and how to ameliorate the effects of incarceration on the risk of either engaging in or being a victim of violence. Bhatt replied that the criminal justice system has to be a critically important part of this discussion.
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