Improved follow-up care for gun violence survivors in the Trauma Quality of Life Clinic. Trauma Surg Acute Care Open 2024;9(1):e001199
Date
02/23/2024Pubmed ID
38390473Pubmed Central ID
PMC10882323DOI
10.1136/tsaco-2023-001199Scopus ID
2-s2.0-85183036845 (requires institutional sign-in at Scopus site) 1 CitationAbstract
BACKGROUND: Outpatient follow-up represents a crucial opportunity to re-engage with gun violence survivors (GVS) and to facilitate positive health outcomes. Current outpatient models for firearm-related injuries and trauma care are inconsistent and unstandardized across trauma centers. This project describes the patient population served by the multidisciplinary Trauma Quality of Life (TQoL) Clinic for GVS. Also of primary interest was the outpatient follow-up services used by patients prior to their clinic appointment. Subsequent referrals placed during Clinic, as well as rate of attendance, was a secondary aim.
METHODS: This was a descriptive retrospective analysis of a quality improvement project of the TQoL Clinic. Data were extracted from the electronic medical record and were supplemented with information from the trauma registry and the hospital-based violence intervention program database. Descriptive statistics characterized the patient population served. A Χ2 analysis was used to compare no-show rates for the TQoL Clinic against two historical cohorts of trauma clinic attendees.
RESULTS: Most attendees were young (M=32.0, SD=1.8, range=15-88 years), Black (80.1%), and male (82.0%). Of the 306 total TQoL Clinic attendees, 82.3% attended their initial scheduled appointment. Most non-attendee patients rescheduled their appointments (92.1%), and 89.5% attended the rescheduled appointment. TQoL Clinic demonstrated a significantly lower no-show rate than the traditional trauma clinic model, including after the implementation of the hospital's inpatient violence intervention program (χ2(2)=75.52, p<0.001).
CONCLUSION: The TQoL Clinic has demonstrated improved outpatient follow-up to address the comprehensive needs of GVS. Trauma centers with high gunshot wound volume should consider the implementation of the multidisciplinary TQoL Clinic model to increase access to care and to continue partnership with violence intervention programs to address health outcomes in those most at risk of future morbidity and mortality.
LEVEL OF EVIDENCE: Therapeutic/care management, level III.
Author List
Brandolino A, deRoon-Cassini TA, Biesboer EA, Tomas CW, Woolfolk M, Wakinekona NA, Subramanian M, Cheruvalath H, Schroeder ME, Trevino CMAuthors
Amber Brandolino in the CTSI department at Medical College of Wisconsin - CTSIMary Elizabeth Schroeder MD Associate Professor in the Surgery department at Medical College of Wisconsin
Carissa W. Tomas PhD Assistant Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Colleen Trevino PhD APP Clinical Dir Inpatient 2 in the Surgery department at Medical College of Wisconsin
Terri A. deRoon Cassini PhD Center Director, Professor in the Surgery department at Medical College of Wisconsin
