Mapping Milwaukee's Blueprint for Peace: Evaluating the Geospatial Reach of a Cure Violence Implementation, 414LIFE.

BACKGROUND: Cure Violence interruption programs are evidence-based interventions aimed at reducing the transmission of gun violence and its related injuries. Assessing the implementation of these programs can include the metric of "reach." This study evaluated one such program - 414LIFE - in Milwaukee, Wisconsin. The evaluation reconceptualized "reach" as a metric for reaching the individuals and neighborhoods at greatest risk for gun violence. METHODS: 414LIFE's reach was analyzed descriptively and geospatially through its program evaluation dataset from May 2019 through September 2020 using a cross-sectional design. Program referral criteria includes patients who sustained a gunshot wound, are less than 36 years old, and a resident of, or injured in, the city of Milwaukee. A choropleth map visualized location of participants' residence, which justified a global Moran's I, and then a local Moran's I calculation to identify statistically significant clustering of referrals. RESULTS: In the first 1.5 years of the program's partnership with the local level I trauma center and affiliated academic medical institution, 398 patients were referred. Three hundred referrals (75.4%) met program criteria; 53.8% were Black men. Statistically significant clusters were identified and mapped. Half of the top 10 neighborhoods with referrals were the city's identified priority neighborhoods. CONCLUSIONS: 414LIFE successfully reaches its intended population and geographic locations. Geospatial reach should be considered routinely in program evaluations of Cure Violence programs to track growth and reach over time.

Addressing the educational gap in the role of law enforcement personnel in the resuscitation bay.

BACKGROUND: Health care workers are often uncertain of the role of law enforcement personnel in the resuscitation bay. A cross-sectional, quality improvement project was designed with an educational intervention to address the knowledge gaps. METHODS: There were 2 sessions for trauma surgery and emergency medicine faculty, residents, and staff. The first was a formal presentation by hospital risk management and security focused on answering questions generated by real-life scenarios. After reviewing feedback from the first session, the second session was designed as a panel discussion led by attending physicians who reviewed various clinical scenarios. A pre/postsurvey was administered, including potential clinical scenarios with multiple-choice answers and open feedback. RESULTS: There were 64 presurvey and 31 postsurvey respondents from the first session (48.4%). Significantly more questions were answered correctly from pre to postsurvey (5.5 vs 6.7/16 questions; U = 798.0, P = .048). Of the 14 (45.2%) respondents who provided open-ended feedback, 50% indicated confusion, and 21.4% expressed strong, negative emotions. In the second session, there were 39 presurvey and 18 postsurvey respondents (46.2%). Again, significantly more questions were answered correctly after the second session (2.2 vs 4.5/7 questions; U = 115.0, P ≤ .001). Feedback highlighted that the panel format was considered more helpful than the formal didactic of the first session. CONCLUSION: Confusion about the role of law enforcement personnel in the clinical environment can be partially addressed using multidisciplinary joint conferences that should be led by clinicians to ensure real-life clinical applicability. Further education and law enforcement personnel role clarification for health care workers are critical to protect patient rights.