A Healthier Wisconsin

A Randomized Controlled Trial of a Post-Discharge Team to Improve Care of Gun Violence Survivors

Addressing the physical, mental, and social needs of gunshot wound patients in order to decrease emergency room utilization and hospital readmissions

Full Project Name:A Randomized Controlled Trial of a Post-Discharge team to Improve Care of Gun Violence SurvivorsPrincipal Investigator:Mary Schroeder, MD, SurgeryCo-Investigator:David Milia, MD, Surgery; Colleen Trevino, DNP, RN, APNP, Surgery; Terri deRoon-Cassini, PhD, SurgeryAward Amount:$200,000
Award Date
Project Duration:24 months

Project Description Narrative:

The U.S. has seen a steady rise in firearm violence in the last several years, with Milwaukee experiencing a 70% increase in nonfatal shootings since 2019. Gunshot wound survivors are a unique patient population predominantly of young, black males from lower socioeconomic status. This population has been historically marginalized by society and the healthcare system.

They present to the hospital with medical, psychological, and social needs ranging from the operative management of their wounds to post-traumatic psychologic care and assistance with financial insecurities post-injury. Clinical follow-up post-discharge is historically low amongst all trauma patients, with this patient population demonstrating a high post-discharge emergency room utilization rate.

Froedtert Hospital has developed innovative programs for survivors of gun violence. These include the community-affiliated violence prevention group; 414LIFE, which works with emergency department and inpatient gunshot wounds, and a trauma quality of life clinic for gunshot outpatients. These programs offer patients holistic, trauma-informed care, but a gap remains between the inpatient and outpatient environments.

The researchers hypothesize that this gap in care can best be addressed by a post-discharge care team comprised of a nurse navigator and a clinical social worker.

A post-discharge care team will optimize recovery and appropriate triaging of clinical resources (i.e., emergency department visits, clinic visits, readmissions, post-op complications, etc.). Post-discharge care teams can improve follow-up and reduce inappropriate utilization of healthcare resources, which has financial benefits for both hospital and patient while improving trust and clinical engagement for gunshot wound patients.

Project Updates:

  • Implemented a post-discharge care team (PDCT) to bridge the gap in care between discharge and clinic follow-up for gunshot wound (GSW) survivors admitted to the trauma service to address the barriers to care faced in their recovery
  • Secured participation of over 150 patients, with half being enrolled in the PDCT
  • Conducted an interim analysis of the first quarter of data to determine the financial impact of the PDCT, finding that the length of initial hospital stay and rates of readmission are similar between the intervention and control groups, but the ED utilization is lower in the PDCT-randomized group such that the total cost of post-discharge readmissions is >$100,000 less than the standard of care-randomized group

AHW Logo

8701 W Watertown Plank Road,
Milwaukee, WI 53226-0509
(414) 955-4350