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Baltimore's Safe Streets Program Aims To Reduce ER Visits

There are many ideas currently in play to address the healthcare concern of reducing ER visits and long wait times. Solutions so far have included freestanding ERs, social workers geared towards educating patients on alternatives to non-ER issues, and even fines to patients who admit themselves for non-ER reasons.

Some efforts aim to target the root socioeconomic issues that indirectly lead to overuse of ERs, while others focus on offering alternative ER services for the wealthy sectors of the country - giving them an option away from the overcrowded central city hospital-based ERs.

A recently NPR.org published article, author Andrea Shu examines one proactive group’s focused efforts in solving a big reason for the high ER visits seen by a U.S. city that has among the highest rate of violence in the country.

Baltimore, the city that saw a nearly record-breaking 344 homicides, and 900 people shot in 2015, piloted the Safe Streets Program in 2009 at Johns Hopkins Hospital, as an innovative approach to reducing the street violence, a leading factor for much of the city’s ER overcrowding.

The program positioned some of the city’s most well-respected former gang members and reformed criminals who wanted to make a difference in the communities as a way of reducing hospital ER visits.

"We don't live in the neighborhood," says Carol Stansbury, director of social work at Johns Hopkins Hospital. She says, "[the Safe Streets workers] brought the love of their neighborhood and the love of their community that we could not bring."

Outreach coordinators would communicate directly with ER patients whose admittance is due to gunshot and stab wounds, or any number of injuries caused by street violence.  

"It makes sense to me, as a social worker, to have people that have walked the walk," added Stansbury, "who certainly understand what the issues are, and the troubles, barriers and obstacles people face. They only help me do my job better."

Oftentimes immediately following an emergency patient's procedure or operation, outreach coordinators would engage the patient to get to the bottom of the ‘beef’ in efforts of bringing the two enemies together for a peaceful meeting of the minds before any retaliations could occur.

Considering the fact that outreach coordinators are made up of prison parolees, former felons, and ex-drug and gang members, it came as no surprise that the program was met with extreme skepticism and was deactivated before it could generate enough results to justify program funding and imminent  discontinuance.

Though it was discontinued, the Baltimore health department did find the hospital responders program valuable, and they now recognize these violence prevention workers as health care providers. The shared goal is to get six or seven hospitals on board with hopes that the hospitals will pay for it, an annual institution cost of nearly $100,000.

"We can look at the people who are victims of violence, and we can treat them four to six times, and obviously it's got a tremendous cost to us," notes Dr. William Jaquis, chief of emergency medicine at Baltimore's Sinai Hospital. "The first time may be a blunt injury, a strike to the head. The next time may be a knife, and the next time may be a gunshot wound. I think what we find is we spend the resources anyway. And so it's starting to look at how we spend them."

The Safe Streets program aims to prove it’s worth, justifying its implementation as a viable healthcare solution focused on improving health outcomes and reducing ER visits.