Keeping teens from being repeat victims of gunshot, knife wounds

Mark Gestring, M.D., a trauma surgeon at the University of Rochester (N.Y.) Medical Center (URMC), was fed up seeing teenagers arrive at the trauma center to be treated for gunshot or knife wounds, only to return weeks or months later with more serious or fatal injuries.

He was fed up, but he didn’t give up. He pulled together a multidisciplinary team from URMC to develop the Rochester Youth Violence Partnership (RYVP), a 10-year-old violence intervention program that is designed to identify at-risk youth immediately after they are brought to the hospital for a knife or gunshot wound and protect them from further injury.

“The goal of this program is to help patients and their families understand that the majority of these injuries are not random and action can be taken now to avoid further injury,” Gestring says. 

RYVP received a 2011 AHA NOVA Award, which recognizes hospital-led partnerships that help build healthier communities. “The hospital is where you have the opportunity to intervene and make an impact,” says Gestring, who believes hospitals have a moral imperative to partner with others to develop violence prevention programs in their communities.

The medical center partners with more than 30 agencies, ranging from law enforcement to schools, social services, churches and community groups to address violence as a community health issue. “We share resources and target those resources to pursue a common goal” of empowering youth to avoid violence, Gestring says.

The program required a significant change in culture within the hospital and strong support from leadership, he says.

“This is not a research project,” Gestring says. “This is not something that is done periodically. This is our standard approach to victims of violence. It’s a 24/7 operation, and I give a lot of credit to our hospital leaders for addressing violence as a public health issue and  recognizing the value in what we are doing.”

The intervention begins at the hospital bedside. After a victim is stabilized and injuries treated, a standardized social-work assessment is performed to identify risk factors. All patients view a video designed for victims and their families while they are still hospitalized.

The video, titled “Views of Violence: Your Chance to Change,” is honest and graphic. “It turns a tragedy into a teachable moment and an opportunity to make a positive change,” Gestring says.

The RYVP intervention team, guided by the social work assessment, develops a safe discharge plan for each teenager linked to follow-up services, such as substance abuse counseling, job placement, educational support, help with finding safer housing and other family support services.  

If bullying or conflict arises at school, the RYVP youth is transferred to another school where there is less likelihood of a problem. School staff also keep a watchful eye on truancy.

About 100 to 120 youths enroll in RYVP every year. The recidivism rate for youth admitted to the hospital for gunshot or knife wounds has steadily declined, according to Gestring. “We see less kids coming back to our hospital after injuries,” he says.

The biggest lesson Gestring has learned from the program is that “as helpless as you may feel at times, there are opportunities to absolutely make a difference.”

Click on http://tinyurl.com/hbxkjzm to hear more about what Gestring has to say about the hospital field’s vital community role in addressing violence.