2 competing health systems partner with community group to quash escalating street violence

The troubling face of urban violence is never more apparent than in a city's trauma centers. Omaha, Neb., is no stranger to street and gang violence that lands its residents in the hospital. In 2018 so far, the Omaha Police Department has reported 1,009 violent crime offenses and 671 aggravated assault incidents.

Much of the violence on the streets of Omaha can be traced back to gang activity. According to data from the Omaha Police Department, there were 2,697 suspected gang members in the city as of the first quarter of 2018.

"We do have a gang problem in Omaha," said Cliff Robertson, MD, CEO of Omaha-based CHI Health. "We've got numerous gangs and we do have a substantial portion of the youth in this greater metropolitan area that are involved in violence and violent behavior. It's a sociocultural problem we need to address."

Charity Evans, MD, a trauma surgeon and associate professor in the department of surgery at Omaha-based University of Nebraska Medical Center, echoed Dr. Robertson, noting that gang violence is a big problem in the city. Nebraska Medicine's trauma team sees a little under 200 victims of violence per year. The violence includes gunshot wounds and stab wounds, as well as assaults. While these victims of violence make up only 7 to 8 percent of the total number of patients seen at the trauma center, the ramifications of the violence are huge, she said.

To help combat this complex issue, the trauma centers at CHI Health and Omaha-based Nebraska Medicine have joined forces with YouTurn, a community organization focused on violence prevention. YouTurn aims to support families in the midst of crises and to defuse any potential violence or retaliation.

"They follow the Cure Violence Model, a model nationwide that is used in multiple trauma centers that basically uses street outreach to interrupt violence," said Dr. Evans. "And part of their initiative under that model is to embed themselves within the hospitals, because we obviously are an entry point for these patients and we have that teachable moment once they're injured — we have their attention for a period of time."

Per the partnership, trained YouTurn outreach workers are alerted when a victim of gang violence has been taken to the trauma center at either CHI Health or Nebraska Medicine. Karen Saxton, MSN, RN, director of Nebraska Medicine's trauma program, noted that either the police or the hospital can notify YouTurn when a victim of street violence comes into a trauma center.

YouTurn outreach workers come to the trauma center to intervene and help mitigate any retaliatory acts of violence. They are debriefed by hospital personnel on the situation. They also work with any family members or friends who come to the hospital campus.

"YouTurn case workers come to centers to interact with the family, to provide comfort and to defuse any further situations that could result from the initial violent act," said Dr. Robertson. "From our perspective, that is great because that is a service and skill-set that we don't have. It's a service they can help provide that I think will be beneficial to all involved."

Dr. Evans said crowd control is another benefit of the YouTurn program.

"Occasionally, [the incident] brings very large crowds," she said. "We've had incidents that'll bring in 40 or 50 people to the hospital. So that involves not only our own security, but it [also] helps to have people [like] a lot of these outreach workers [who] are from these communities and are familiar to people from these communities. So when they walk in the room, I think they bring kind of a peaceful presence."

The trauma centers at Nebraska Medicine and CHI Health began partnering with YouTurn in recent months. Thus far, YouTurn members have responded to patients at both organizations' trauma centers on 10 different occasions, Ms. Saxton said.

The partnership is brand new, but exciting, said Dr. Robertson. He highlighted the fact that two competing health systems have come together to partner with this community group, noting it is a testament to the community spirit in Omaha.

However, the measurable effects of the partnership will only be seen in the coming months.

"Our ultimate goal is to have a bunch of trauma surgeons who can't remember the last time they saw a gunshot wound," said Dr. Robertson. "I think that's the best way to describe what success would look like [for us]. Violence is a huge community health problem — it really is a public health problem that we all need to try and address."

 

 

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