WIP 09 - Improving enrollment of eligible patients into a hospital-based violence intervention program

Publication Number: WIP 09.7388

Narmeen I. Khan, Medical College of Wisconsin, Wauwatosa, WI, United States; sri S. chinta, Medical College of Wisconsin/children's hospital of wisconsi, milwaukee, WI, United States; Brooke M. Cheaton, Children's Hospital of Wisconsin, Milwaukee, WI, United States; Mark Nimmer, Children's Wisconsin, Milwaukee, WI, United States; Sarah E. Miller, Medical College of Wisconsin, Wauwatosa, WI, United States; Michael N. Levas, Medical College of Wisconsin, Pewaukee, WI, 53072, WI, United States

Background: Hospital-based violence intervention programs (HVIPs) reduce violent injury recidivism rates for victims of interpersonal violence. Past improvement efforts at our pediatric tertiary care hospital increased emergency department (ED) to HVIP referrals from 51% to 90%. However, the increase in referrals have not translated to increase in enrollment rates.

Objective: Our SMART aim is to improve enrollment of patients referred to our HVIP from 20% to 50% over a 12-month period.

Design/Methods: Our study population encompasses patients 0 to 18 years of age who present to our ED and are eligible for the HVIP, including those who sustain gunshot wounds or other forms of physical assault. Exclusionary criteria include involvement with child protective services. Eligible patients are identified through triggers within the electronic medical record. All referred patient information is then entered into a secure database which includes reasons why enrollment was declined by a patient or family member and what services were received.

Stakeholders encompass HVIP leaders, crime victim advocates (HVIP staff who have face-to-face contact with caregivers of eligible patients), and caregivers. Key drivers include accessibility of crime victim advocates, collaboration with caregivers, and streamlining of various program uptake reports. We are doing a root cause analysis by interviewing stakeholders to understand reasons for low enrollment. Our primary outcome measure is percentage of enrolled individuals from those referred, highlighted by a process control chart. One of our process measures is percentage of caregivers contacted. Other patient-centered outcome measures include resource utilization, measured via a social needs assessment obtained at various points during enrollment. Post-intervention trends of outcome and process measures will be mapped through March 2025.