Injury prevention leaders share program development strategies


How can you make your injury prevention program more effective? Leaders from three Level I trauma centers shared proven strategies for building a strong injury prevention program during a session at the 2016 Annual Conference of the Trauma Center Association of America. The speakers discussed ways to develop funding sources, build public support for IP initiatives and create a strong program structure.

Securing ongoing sources of funding
Joanne Fairchild, RN, injury prevention nurse consultant at Legacy Emmanuel Hospital in Portland, Oregon, talked about effective strategies for securing funds for injury prevention.

“The key is to start small and partner with people in your community,” Fairchild said in a separate interview. Among her biggest successes are court-ordered classes for people who have received citations for high-risk driving behaviors. “We got the courts to agree to let us use these citations as an opportunity to teach, and we got the hospital to agree that any money generated through these classes would go to the injury prevention program.”

The initiative depends on community partnerships. “We work very closely with law enforcement on this,” Fairchild said. “People come to the class in lieu of paying a fine, and law enforcement basically writes the invitation.”

During the panel discussion, Fairchild talked about strategies for working effectively with private funding groups. She described how she was able to secure support from groups as diverse as local trucking and clothing companies, restaurants and a trial lawyers association.

Fairchild also spoke about how hospital foundation staff can support IP fundraising. She said it is important to talk to foundation staff before you embark on community fundraising to ensure your efforts do not overlap with any of their work.

Networking with community leaders
Tara Reed Carlson MS, RN, business development manager at the R Adams Cowley Shock Trauma Center in Baltimore, discussed ways to build non-financial support for injury prevention programs.

“Networking with government representatives and community leaders is important to garnering support for injury prevention,” said Carlson in an interview. “After every election, we invite the freshman legislators to tour our facility. If there is a new mayor or a new health commissioner, we welcome them to our trauma center and show them around.”

These personal links eventually pay off. “When we have to reach out to those people later about injury prevention issues, we already have an established relationship,” she said. “The key is to keep it non-partisan. Invite everybody.”

During the session, Carlson talked about the power of personally lobbying elected officials. She shared the “ten commandments of lobbying”:

  1. Do your homework — when talking to legislators, know the issues surrounding a piece of legislation and how it affects your trauma center.
  2. Tell the truth — maintaining trust is essential to creating a long-term relationship.
  3. Thank legislators — for both their time and their support.
  4. Know how the process works — understand the mechanics of the legislative process.
  5. Know the staff — legislative staff members are powerful, and they will likely have more time to give personal attention to your concerns.
  6. Build coalitions — identify groups that agree with your position and figure out how you can support each other.
  7. Keep it simple — all legislators and staff are extremely busy, so be ready to provide a concise summary of the issues and your organization’s viewpoint.
  8. Know your bottom line — ask for what your organization needs, but understand what you regard as the minimum acceptable
  9. Know your opponents — be ready to counter their objections, and identify opponents who could be persuaded to your point of view.
  10. Work at the local level — local legislators are generally the most responsive to constituent concerns.

Carlson, who is also director of Shock Trauma’s Center for Injury Prevention and Policy, also talked about how to leverage news events to educate legislators and the community and build support for injury prevention legislation.

Structuring an effective IP program
According to the Orange Book, verified trauma centers must have “an organized and effective approach” to injury prevention. Stewart Williams, injury prevention manager at Dell Children’s Medical Center in Austin, Texas, discussed ways to structure an IP program to meet this requirement.

“In Texas, IP leaders identified five key components of an effective injury prevention program,” Williams said in an interview. The purpose was to strengthen hospital-based injury prevention efforts by establishing a solid foundation to operate from consistently. “One of these key components is selecting and implementing evidence-informed strategies. The goal is to implement true public health strategies — population-based injury prevention initiatives that are rooted in evidence.”

As an example, Williams noted that there is little research on how to prevent texting while driving. “There are a lot of ideas, but very little evidence.”

In contrast, significant evidence exists for prevention strategies related to elderly falls. “We know that home risk assessments and polypharmacy reviews are effective,” he said. “There has also been a lot of research in recent years around the value of keeping older people active via things like tai chi and other exercise programs.”

During the session, Williams noted that there is growing evidence that “fear-based” approaches to injury prevention are ineffective and even counter-productive. “When we go to people and say, ‘You will die if you do this, you will die if you do that,’ etc., audiences immediately back off and turn away,” he said. “We need to think beyond the ‘death educator’ mindset.”

Williams argued that injury prevention efforts should focus less on one-to-one efforts and more on “population health” strategies. He noted that counseling, education and clinical interventions require high levels of individual effort.

“Clinical interventions work, but tend to be very very specific and targeted to specific patient populations, as they should be,” he said. “This limits them. My key point is that we must work in all layers to address injury, not remain focused on simply educating people. Trauma systems are uniquely positioned to impact injury if true population health is applied.”

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