An exploration of factors impacting implementation of a multisystem hospital-based violence intervention program

Community violence, particularly gun violence, is a leading cause of morbidity and mortality in young people in the United States. Because persons experiencing violence-related injuries are likely to receive medical care through emergency departments, hospitals are increasingly seen as primary locations for violence intervention services. Currently, there is little research on how best to implement hospital-based violence intervention programs (HVIPs) across large hospital systems. This study explored the factors influencing the implementation of a multi-site HVIP using qualitative interviews with a purposive sample of 20 multidisciplinary stakeholders. Thematic analysis was used to generate several themes that included: (1) reframing gun violence as a public health issue; (2) developing networks of community-hospital-university partners; (3) demonstrating effectiveness and community benefit; and (4) establishing patient engagement pathways. Effective implementation and sustainment of HVIPs requires robust and sustained multidisciplinary partnerships within and across hospital systems and the establishment of HVIPs as a standard of care.