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Injuries resulting from interpersonal violence in the U.S. are all too common. In 2015, homicide was the sixth leading cause of death for all age
groups. It was the third leading cause of death in
15- to 34-year-olds, and fourth in children 10 to 14
years of age. Interpersonal violence disproportionately affects minority populations, and homicide is
the leading cause of death in young ( 15 to 24 years
old) African Americans and second among young
Hispanics. Nearly 1. 5 million nonfatal injuries
occur among 15- to 34-year-olds, and the direct and
indirect cost of these injuries is approximately $12
billion.
Trauma centers stand on the front lines of this
interpersonal violence epidemic. With injury recidivism rates as high as 55 percent, injury prevention
advocates are exploring ways to close this revolving door to decrease violent injury, using similar
methods to those that have been used effectively
to reduce the incidence of cardiovascular disease
and cancer. Approaching interpersonal violence
prevention as a public health issue would allow
practitioners to identify risk and protective factors
to prevent recurrent injury.
To begin a program to reduce risk factors associated with violent injury, a comprehensive approach
that addresses mental health and social determinants of health is critical. Hospital-based violence
intervention programs (HVIPs) are multidisciplinary programs that identify patients at risk of
repeat violent injury and link them with hospital-and community-based resources aimed at addressing
underlying risk factors for violence. Data indicate
that HVIPs can reduce violent injury recidivism and
hospital costs.
A group from the American College of Surgeons
Committee on Trauma (ACS COT) Injury Prevention
and Control Committee was tasked with outlining
a comprehensive approach to institute a sustainable
HVIP. The following is a summary of the concepts
outlined in the “Violence Intervention Programs: A
Primer for Developing a Comprehensive Program
within Trauma Centers” developed by this group in
August 2017 to guide fledgling programs and perhaps save new programs from the pitfalls that often
accompany this difficult work (see Figure 1, page 22).
The complete primer is available on the ACS COT
website at facs.org/quality-programs/trauma/ipc.
Violence
intervention
programs:
by Rochelle A. Dicker, MD, FACS; Barbara A. Gaines, MD, FACS; Stephanie Bonne, MD, FACS;
Thomas Duncan, DO, FACS; Pina Violano, PhD, MSPH, RN-BC, CCRN, CPS-T;
Michel Aboutanos, MD, MPH, FACS; Lisa Allee, MSW, LICSW; Peter A. Burke, MD, FACS;
Peter T. Masiakos, MD, FACS; Ashley Hink, MD; Deborah A. Kuhls, MD, FACS, FCCM;
David Shapiro, MD, FACS; and Ronald M. Stewart, MD, FACS
A primer
for developing
a comprehensive
program
for trauma centers
