Two-tiered education program increases knowledge and confidence in addressing firearm injury risk in emergency departments

Gun violence is a leading cause of death for American children, surpassing even car accidents. While health care systems are urged to implement violence prevention strategies, a concrete plan to educate frontline workers has been lacking. Northwell Health's firearm injury prevention program for health care professionals, detailed in a study published in Injury Prevention, addresses this gap. Researchers from the Feinstein Institutes for Medical Research and Northwell’s Center for Gun Violence Prevention have provided a blueprint for implementing effective universal screening for firearm injury and mortality prevention strategies in emergency care settings, emphasizing the critical need for educating health professionals on how to approach and navigate this public health crisis.

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A Northwell Health firearm safety awareness badge rests on a gun violence prevention t-shirt. (Credit: Northwell Health)

Research led by Laura Harrison, MPH; Chethan Sathya, MD; Monica Shekher-Kapoor, MD; Stephen Butkus, MS; and Sandeep Kapoor, MD, builds upon Northwell’s successful system-level Screening, Brief Intervention and Referral to Treatment (SBIRT) program for addressing substance use through universal screening to develop its Firearm Injury and Mortality Prevention program (FIMP). The study focuses on equipping health care professionals with the knowledge and skills to implement firearm injury and mortality prevention strategies in emergency care settings.

The new study, spanning across three Northwell emergency departments, found that the FIMP health care worker education program significantly increased participant knowledge and confidence in addressing firearm injury risk with strategies like universal patient screening.

• Screening Education: Provided to all team members involved in screening patients for firearm access and violence risk. This education covered topics such as the prevalence of firearm injury, evidence-based screening tools and available resources for patients and families.

• Intervention Education: Offered to team members who meet with patients identified as at-risk for firearm injury. This training focused on motivational interviewing techniques, brief intervention strategies and resources to support patient safety.

“Educating our health care professionals is a crucial first step in empowering our frontliners with the skills they need to feel confident to better screen and address firearm injury risk,” said Dr. Sathya, director of the Center for Gun Violence Prevention and co-author of the paper. “By providing team members with the knowledge and resources they need, we can create a safer environment for our patients and communities and move the needle on senseless gun violence.”

Key findings demonstrated that participants gained a better understanding of firearm injury prevalence, risk factors and evidence-based prevention strategies. Team members also expressed improved confidence in their ability to screen patients for firearm risk and provide brief interventions. This education program successfully facilitated the implementation of firearm injury prevention protocols in the pilot emergency departments.

“Our firearm injury prevention education for team members is modeled off our successful approach to educating team members on addressing substance use as part of usual care with patients,” said Ms. Harrison, senior research scientist for emergency medicine addiction services at Northwell and lead author of the paper. “Our study shows that small, actionable steps can have a significant impact. Through sufficient time, education and resources, we can empower our team members to effectively and humanistically screen for and address firearm access and violence risk.”

Since 2019, Northwell Health, New York's largest health system, has been a leader in addressing gun violence as a public health crisis. Through its Center for Gun Violence Prevention, Northwell has screened over 50,000 patients for firearm access and gun violence risk, including children presenting in the emergency department. The health system continues to invest in gun violence research, including screening emergency room patients for risk of gun violence, and safe firearm storage practices.

“Gun violence is a public health crisis, and it is imperative that our frontline health care workers are equipped with the tools they need to assess risk and educate their patients,” said Michael J. Dowling, Northwell’s president and CEO. “Dr. Sathya and his team’s ongoing work at Northwell, in partnership with the community, government officials and other groups are making a difference.”

Every year, Northwell hosts its Gun Violence Prevention Forum, bringing together leaders, advocates and community members for an open dialogue on the state of the gun violence epidemic while offering strategies to implement change. The center also spearheaded the Gun Violence Prevention Learning Collaborative for Hospitals, in which over 600 hospitals from 38 states have come together to advance best practices. Through the Northwell-initiated National Health Care CEO Council on Gun Violence Prevention & Safety, 54 leading health care CEOs have pledged to leverage their collective influence and resources to curb the historic spike in gun-related deaths and injuries.

For more information about Northwell Health’s gun violence prevention efforts, please click here.

About Northwell Health

Northwell Health is New York State’s largest health care provider and private employer, with 21 hospitals, about 900 outpatient facilities and more than 12,000 affiliated physicians. We care for over two million people annually in the New York metro area and beyond, thanks to philanthropic support from our communities. Our 87,000 employees – 18,900 nurses and 4,900 employed doctors, including members of Northwell Health Physician Partners – are working to change health care for the better. We’re making breakthroughs in medicine at the Feinstein Institutes for Medical Research. We're training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Nursing and Physician Assistant Studies. For information on our more than 100 medical specialties, visit Northwell.edu and follow us @NorthwellHealth on Facebook, Twitter, Instagram and LinkedIn.

About the Feinstein Institutes

The Feinstein Institutes for Medical Research is the home of the research institutes of Northwell Health, the largest health care provider and private employer in New York State. Encompassing 50 research labs, 3,000 clinical research studies and 5,000 researchers and staff, the Feinstein Institutes raises the standard of medical innovation through its five institutes of behavioral science, bioelectronic medicine, cancer, health system science, and molecular medicine. We make breakthroughs in genetics, oncology, brain research, mental health, autoimmunity, and are the global scientific leader in bioelectronic medicine – a new field of science that has the potential to revolutionize medicine. For more information about how we produce knowledge to cure disease, visit http://feinstein.northwell.edu and follow us on LinkedIn.

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