Published by: Gerardo Gomez on 1/12/2011 11:58:44 AM
Statistics show that there are nearly 1.5 million violent crimes committed every year in the United States, and that homicide is the second leading cause of death in people 15-24 years of age. In addition, recent acts of violence, such as the tragic mass shooting that occurred in Arizona, have catapulted the issue into the national spotlight. As a trauma surgeon at Wishard Health Services in Indianapolis, I am all too familiar with the impact that violence can have on a community.
Last year, in Indianapolis alone there were over 100 homicides in the metro area. In 2009, the IU/Wishard Level I Trauma Center documented 1,414 admissions meeting trauma criteria. Admissions for violent injury totaled 521 with 233 or 44 percent of total violent injuries resulting from gunshots, 199 or 38 percent from stabbings and 89 or 17 percent from other forms of assault.
For all diseases including traumatic injuries the best medicine has always been prevention – if you prevent the disease you don’t have to treat the disease. This is why nearly two years ago, through support from hospital administrators, community organizations and city and law enforcement leaders, Wishard established the Prescription for Hope program. The program is modeled after an initiative at San Francisco General Hospital and aims to identify, and as much as possible, eliminate the causes of preventable injuries, including unsafe behaviors, conditions and environments by reducing the readmission of trauma patients.
Initial data from the program, taken between June 1, 2009 and May 31, 2010, shows that 116 patients and family members participated in the program and that 89 percent of the participants remained in the program. During that time, not one of those participants returned to the trauma center as a result of an injury resulting from violence and no family member experienced a first-time violent injury.
The national recidivism rate for injuries due to violence has been reported to be between 30 and 50 percent. According to a 2007 study published in the Journal of the American College of Surgeons, penetrating trauma from gunshots, stab wounds and assaults is a robust predictor of future violent injury.
At Wishard, Prescription for Hope team members help enroll recovering individuals in a life skills mentoring program to prevent a return to the hospital with another violence-related injury or even death. Case management, counseling and referrals for these individuals are used to reduce the risk of the patient being involved in future criminal activities. Housing, education, job skills, employment, relationship building and healthcare, including treatment for substance abuse, are some of the areas of focus.
Prior to implementing our Prescription for Hope program, nearly a third of our patients who experienced a violent injury returned to our trauma center with injuries due to violence. This focus on reducing the threat of repeated violent injury and criminal activity, while helping individuals make life changing and life saving choices, teamed with the efforts of city and law enforcement leaders, will continue to curb violence in our city. The success of our program at Wishard is proof that community-focused initiatives can make a difference in reducing violent crime in Indianapolis.
Gerardo Gomez, MD
Chief of the Division of Trauma, Surgical Critical Care and Emergency Surgical Services at Wishard Medical Director, IU/Wishard level I Trauma Center