From the Division of General Surgery, Lahey Hospital and Medical Center (M.S.R.), Burlington, Massachusetts; Department of Trauma and Burns, John H. Stroger Hospital of Cook County (K.T.J.), Chicago, Illinois; Department of Surgery, Boston University School of Medicine (T.D.), Boston, Massachusetts; Department of Trauma, Ventura County Medical Center (T.K.D.), Ventura, California; Critical Care and Emergency General Surgery, NYU-Winthrop Hospital (D'A.K.J.), Mineola, New York; Department of Surgery, University of Texas Health Science Center (R.M.S.), San Antonio, Texas; and Center for Surgery and Public Health, Brigham and Women's Hospital (Z.R.C.), Boston, Massachusetts.
J Trauma Acute Care Surg. 2019 Aug;87(2):456-462. doi: 10.1097/TA.0000000000002313.
An effective injury prevention program is an important component of a successful trauma system. Maintaining support for a hospital-based injury prevention program is challenging, given competing institutional and trauma program priorities and limited resources. In light of those pressures, the American College of Surgeons Committee on Trauma mandates that trauma centers demonstrate financial support for an injury prevention program as part of the verification process, recognizing that hospital administrators might see such support as discretionary and ripe as a target for expense reduction efforts. This Topical Update from the American Association for the Surgery of Trauma Injury Prevention Committee focuses on strategies to be more effective with the limited resources that are allocated to hospital-based injury prevention programs. First, this review tackles two of the many social determinates of violence, including activities aimed at mitigating the impact of both community violence exposure and intimate partner/domestic violence. Developing or participating in coalitions for injury prevention, both in general with any injury prevention initiative, and specifically while developing a hospital-based violence intervention program, efficiently extends the hospital's efforts by gaining access to expertise, resources, and influence over the target population that the hospital might otherwise have difficulty impacting. Finally, the importance of systematic program evaluation is explored. In an era of dwindling resources for injury prevention, both at the national level and the institutional level, it is important to measure the effectiveness of injury prevention efforts on the target population, and when necessary, make changes to programs to both improve their effectiveness and to assist organizations in making wise choices in the use of their limited resources.
有效的伤害预防计划是成功创伤系统的重要组成部分。由于机构和创伤计划的优先事项竞争以及资源有限，维持对基于医院的伤害预防计划的支持具有挑战性。鉴于这些压力，美国外科医师学会创伤委员会要求创伤中心在验证过程中展示对伤害预防计划的财务支持，认识到医院管理人员可能会将这种支持视为可自由支配的，并将其视为减少开支努力的目标。美国创伤外科学会伤害预防委员会的这篇专题更新重点介绍了在分配给基于医院的伤害预防计划的有限资源中更有效地发挥作用的策略。首先，本综述探讨了暴力的两个众多社会决定因素之一，包括旨在减轻社区暴力暴露和亲密伴侣/家庭暴力影响的活动。通过参与或组建伤害预防联盟，无论是在一般的伤害预防倡议中，还是在制定基于医院的暴力干预计划时，都可以有效地利用医院的影响力，为目标人群提供专业知识、资源和影响力，从而扩大医院的影响力。最后，探讨了系统的项目评估的重要性。在国家和机构层面，伤害预防资源日益减少的时代，衡量伤害预防工作对目标人群的有效性非常重要，并且在必要时，对项目进行更改，以提高其有效性，并帮助组织明智地选择有限资源的使用。
