Format

Send to

Choose Destination
J Surg Res. 2017 Sep;217:177-186.e2. doi: 10.1016/j.jss.2017.05.023. Epub 2017 May 11.

Violent reinjury risk assessment instrument (VRRAI) for hospital-based violence intervention programs.

Author information

1
Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut. Electronic address: erik.kramer@yale.edu.
2
Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut.
3
Department of Surgery, University of California San Francisco, San Francisco, California.

Abstract

BACKGROUND:

Violent injury is the second most common cause of death among 15- to 24-year olds in the US. Up to 58% of violently injured youth return to the hospital with a second violent injury. Hospital-based violence intervention programs (HVIPs) have been shown to reduce injury recidivism through intensive case management. However, no validated guidelines for risk assessment strategies in the HVIP setting have been reported. We aimed to use qualitative methods to investigate the key components of risk assessments employed by HVIP case managers and to propose a risk assessment model based on this qualitative analysis.

MATERIALS AND METHODS:

An established academic hospital-affiliated HVIP served as the nexus for this research. Thematic saturation was reached with 11 semi-structured interviews and two focus groups conducted with HVIP case managers and key informants identified through snowball sampling. Interactions were analyzed by a four-member team using Nvivo 10, employing the constant comparison method. Risk factors identified were used to create a set of models presented in two follow-up HVIP case managers and leadership focus groups.

RESULTS:

Eighteen key themes within seven domains (environment, identity, mental health, behavior, conflict, indicators of lower risk, and case management) and 141 potential risk factors for use in the risk assessment framework were identified. The most salient factors were incorporated into eight models that were presented to the HVIP case managers. A 29-item algorithmic structured professional judgment model was chosen.

CONCLUSIONS:

We identified four tiers of risk factors for violent reinjury that were incorporated into a proposed risk assessment instrument, VRRAI.

KEYWORDS:

Hospital-based violence intervention program; Risk assessment; Trauma; Violent injury

PMID:
28602221
PMCID:
PMC5647140
DOI:
10.1016/j.jss.2017.05.023
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center