Hospital-Based Violence Prevention: Progress and Opportunities
Authors: Jonathan Purtle, John A. Rich, Joel A. Fein, Thea James, Theodore J. Corbin
Journal: Annals of Internal Medicine (2015)

Ideas and Opinions3 November 2015Hospital-Based Violence Prevention: Progress and OpportunitiesJonathan Purtle, DrPH, MSc, John A. Rich, MD, MPH, Joel A. Fein, MD, MPH, Thea James, MD, and Theodore J. Corbin, MD, MPPJonathan Purtle, DrPH, MScFrom Drexel University School of Public Health, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, and Drexel University College of Medicine, Philadelphia, Pennsylvania, and Boston University School of Medicine, Boston, Massachusetts., John A. Rich, MD, MPHFrom Drexel University School of Public Health, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, and Drexel University College of Medicine, Philadelphia, Pennsylvania, and Boston University School of Medicine, Boston, Massachusetts., Joel A. Fein, MD, MPHFrom Drexel University School of Public Health, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, and Drexel University College of Medicine, Philadelphia, Pennsylvania, and Boston University School of Medicine, Boston, Massachusetts., Thea James, MDFrom Drexel University School of Public Health, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, and Drexel University College of Medicine, Philadelphia, Pennsylvania, and Boston University School of Medicine, Boston, Massachusetts., and Theodore J. Corbin, MD, MPPFrom Drexel University School of Public Health, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, and Drexel University College of Medicine, Philadelphia, Pennsylvania, and Boston University School of Medicine, Boston, Massachusetts.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-0586 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A substantial body of research shows that violently injured patients are at high risk for violent reinjury, violence perpetration, and symptoms of posttraumatic stress (1, 2). The standard of care for assault injury, however, does not reflect this knowledge—physical wounds are treated and patients are discharged, often to return with repeated injuries. Although many physicians wish to act on this knowledge, as evidenced by a recent call to action endorsed by 8 medical societies (3), little concrete guidance on what they can do is available. In this commentary, we describe how hospital-based violence intervention programs (HVIPs) work to translate research ...References1. Cunningham RM, Carter PM, Ranney M, Zimmerman MA, Blow FC, Booth BM, et al. Violent reinjury and mortality among youth seeking emergency department care for assault-related injury: a 2-year prospective cohort study. JAMA Pediatr. 2015;169:63-70. [PMID: 25365147] doi:10.1001/jamapediatrics.2014.1900 CrossrefMedlineGoogle Scholar2. Rowhani-Rahbar A, Zatzick D, Wang J, Mills BM, Simonetti JA, Fan MD, et al. Firearm-related hospitalization and risk for subsequent violent injury, death, or crime perpetration: a cohort study. Ann Intern Med. 2015;162:492-500. [PMID: 25706337]. doi:10.7326/M14-2362 LinkGoogle Scholar3. Weinberger SE, Hoyt DB, Lawrence HC, Levin S, Henley DE, Alden ER, et al. Firearm-related injury and death in the United States: a call to action from 8 health professional organizations and the American Bar Association. Ann Intern Med. 2015;162:513-6. [PMID: 25706470]. doi:10.7326/M15-0337 LinkGoogle Scholar4. Purtle J, Corbin TJ, Rich LJ, Rich JA. Hospitals as a locus for violence intervention.. In: Donnelly PD, Ward CL, eds. Oxford Textbook of Violence Prevention: Epidemiology, Evidence, and Policy. Oxford, UK: Oxford Univ Pr; 2014. Google Scholar5. Snider C, Lee J. Youth violence secondary prevention initiatives in emergency departments: a systematic review. CJEM. 2009;11:161-8. [PMID: 19272218] CrossrefMedlineGoogle Scholar6. Purtle J, Rich LJ, Bloom SL, Rich JA, Corbin TJ. Cost-benefit analysis simulation of a hospital-based violence intervention program. Am J Prev Med. 2015;48:162-9. [PMID: 25442223] doi:10.1016/j.amepre.2014.08.030 CrossrefMedlineGoogle Scholar7. Cooper C, Eslinger DM, Stolley PD. Hospital-based violence intervention programs work. J Trauma. 2006;61:534-7. [PMID: 16966983] CrossrefMedlineGoogle Scholar8. van der Westhuizen C, Sorsdahl K, Wyatt G, Williams J, Siegfried N, Stein DJ. Psychosocial interventions in the emergency centre setting for preventing reinjury due to interpersonal violence (protocol). Cochrane Database Syst Rev. 2013. doi:10.1002/14651858.CD010839 CrossrefGoogle Scholar9. Juillard C, Smith R, Anaya N, Garcia A, Kahn JG, Dicker RA. Saving lives and saving money: hospital-based violence intervention is cost-effective. J Trauma Acute Care Surg. 2015;78:252-7. [PMID: 25757108] doi:10.1097/TA.0000000000000527 CrossrefMedlineGoogle Scholar10. James TL, Bibi S, Langlois BK, Dugan E, Mitchell PM. Boston Violence Intervention Advocacy Program: a qualitative study of client experiences and perceived effect. Acad Emerg Med. 2014;21:742-51. [PMID: 25039818] doi:10.1111/acem.12409 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Jonathan Purtle, DrPH, MSc; John A. Rich, MD, MPH; Joel A. Fein, MD, MPH; Thea James, MD; Theodore J. Corbin, MD, MPPAffiliations: From Drexel University School of Public Health, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, and Drexel University College of Medicine, Philadelphia, Pennsylvania, and Boston University School of Medicine, Boston, Massachusetts.Grant Support: Drs. Purtle, Rich, and Corbin were supported by the Philadelphia Department of Behavioral Health in Disability Services, the Stoneleigh Foundation, and The Annie E. Casey Foundation. Dr. Fein was supported by the Violence Prevention Initiative of The Children's Hospital of Philadelphia. Dr. James is supported by the Boston Medical Center, the Boston Public Health Commission, the Massachusetts Department of Public Heath, The Boston Foundation, and the Robert Wood Johnson Foundation.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-0586.Corresponding Author: Jonathan Purtle, DrPH, MSc, Drexel University, Nesbitt Hall, 3rd Floor, 3215 Market Street, Philadelphia, PA 19104; e-mail, [email protected]edu.Current Author Addresses: Dr. Purtle: Drexel University, Nesbitt Hall, 3rd Floor, 3215 Market Street, Philadelphia, PA 19104.Drs. Rich and Corbin: Drexel University, 1505 Race Street, MS 1047, Philadelphia, PA 19102.Dr. Fein: 3501 Civic Center Boulevard, Emergency Department, CTRB, 9th Floor, Philadelphia, PA 19104.Dr. James: Boston Medical Center, Department of Emergency Medicine, Dowling 1 South, 818 Harrison Avenue, Boston, MA 02118.Author Contributions: Conception and design: J. Purtle, J.A. Fein, T.J. Corbin.Drafting of the article: J. Purtle, J.A. Rich, J.A. Fein, T. James, T.J. Corbin.Critical revision of the article for important intellectual content: J. Purtle, J.A. Rich, J.A. Fein, T.J. Corbin.Final approval of the article: J. Purtle, J.A. Rich, J.A. Fein, T. James, T.J. Corbin.Collection and assembly of data: T.J. Corbin.This article was published online first at www.annals.org on 25 August 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHospital-Based Violence Intervention Programs (HVIPs): Making a Case for Qualitative Evaluation DesignsA mixed methods protocol to implement universal firearm injury risk screening and intervention among youth and adults in emergency departments across a large US health systemImplementation of a Novel Home Visiting Nurse Pilot Program for Victims of Violent Penetrating InjuryMechanism of penetrating injury mediates the risk of long-term adverse outcomes for survivors of violent traumaGender Differences in Violent Penetrating Injuries and Long-Term Adverse OutcomesBoston Violence Intervention Advocacy Program: Challenges and Opportunities for Client Engagement and Goal AchievementViolence Intervention Advocacy Program and Community InterventionsAge-specific incidence of injury-related hospital contact after release from prison: a prospective data-linkage studyPreventing Firearm Violence in Youth Through Evidence-Informed StrategiesRates and correlates of risky firearm behaviors among adolescents and young adults treated in an urban emergency departmentReflections: A Social Emergency Medicine Call to Arms: Promoting the Adoption of Social Emergency Medicine PracticesReducing gunshot victimization in high-risk social networks through direct and spillover effectsViolence And The US Health Care Sector: Burden And ResponseFirearm Violence and the Path to Prevention: What We Know, What We NeedA Content Analysis of Hospitals' Community Health Needs Assessments in the Most Violent U.S. CitiesViolent victimization and health service utilization in a forensic psychiatric context: a comparison between offenders with mental disorders and matched controlsViolent firearm-related conflicts among high-risk youth: An event-level and daily calendar analysisDevelopment of the SaFETy Score: A Clinical Screening Tool for Predicting Future Firearm Violence RiskJason E. Goldstick, PhD, Patrick M. Carter, MD, Maureen A. Walton, MPH, PhD, Linda L. Dahlberg, PhD, Steven A. Sumner, MD, MSc, Marc A. Zimmerman, PhD, and Rebecca M. Cunningham, MDYes, You Can: Physicians, Patients, and FirearmsGaren J. Wintemute, MD, MPH, Marian E. Betz, MD, MPH, and Megan L. Ranney, MD, MPH 3 November 2015Volume 163, Issue 9Page: 715-717KeywordsAssaultChildrenEmergency departmentHealth economicsHealth insuranceMedicarePatient Protection and Affordable Care ActPosttraumatic stressSafetyViolent crime ePublished: 25 August 2015 Issue Published: 3 November 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...