Boyle, Adrian

Sheehan, David

Shepherd, Jonathan Paul

Online Research @ Cardiff

Excellence in Emergency Care  Incorporated by Royal Charter, 2008     •     Registered Charity number 1122689   The College of Emergency Medicine  Patron: HRH The Princess Royal  Churchill House   Tel +44 (0)207 404 1999      35 Red Lion Square  Fax +44 (0)207 067 1267 London WC1R 4SG www.collemergencymed.ac.uk    CLINICAL EFFECTIVENESS COMMITTEE Guideline for information sharing to reduce  community violence   Summary of recommendations  1. Emergency departments should routinely collect, electronically wherever possible, data about assault victims at registration. Receptionists should collect the date and time of the assault, the location (name of pub, club, school, street etc) of the assault in free text and which weapon (fist, foot and so on was used.)  2. There is no need for a formal information sharing agreement between the Emergency department and the Community Safety Partnership (CSP).  3. This data should be shared with the local CSP and crime analysts in an anonymous and aggregate form.  4. Senior emergency physicians should be supported to participate in CSP meetings.   Information Sharing to Reduce Community Violence in EDs September 2009 (Revised May 2010 & Aug 2011)  - 2 -  Scope This guideline is to assist Emergency Physicians sharing data with Community Safety Partnerships (formerly known as Crime and Disorder Reduction Partnerships in England) to reduce community violence.   Reason for development This guideline has been prepared to help implement Best Practice.   Introduction  Around 80% of assault victims requiring emergency department treatment do not report their assault to the police. 1 2 Work from Cardiff and the South East of England has shown that data collection by emergency department receptionists that is shared with Community Safety Partnerships (CSPs) is very effective in reducing the number of assaults requiring emergency department treatment. 3 (Level 3 evidence) At best, this can lead to 30% reductions in the number of attendances for assault. Anonymous data needs to be shared monthly with local crime analysts. This informs targeted policing of ‘problem premises’ and violence hotspots. An example of the data format is shown below.   Receptionists are the best people to collect this data at registration. Only three additional items are required. These are shown in the figure below. The data should be shared monthly with the crime analysts. There is no need for a formal information sharing agreement as the data is anonymous.   The effectiveness of this information sharing process is considerably enhanced if a senior emergency physician from the emergency department attends the CSP meetings.   This guidance does not replace the responsibilities of emergency physicians to promptly inform the police in cases of firearms and stabbings. The GMC guidance on reporting gunshot wounds and knife wounds should be followed.   www.gmc-uk.org/guidance/ethical_guidance/confidentiality.asp Useful information about implementing this can be found on the Department of Health website:  http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_084703   More information about Community Safety Partnerships can be found on the Home Office website:  http://www.homeoffice.gov.uk/crime/partnerships/ Information Sharing to Reduce Community Violence in EDs September 2009 (Revised May 2010 & Aug 2011)  - 3 - Data items to be collected by ED receptionists                             Incident Type Assault Date & time of assault Assault Type Assault location Body Part Weapon Pushed Unknown  Body Part Fist Feet Head Other Weapon Glass Bottle Knife Blunt object Gun Other    Bar/pub Club Street Own home Someone else’s home Workplace Other  Free text facility to give specific details of the location Information Sharing to Reduce Community Violence in EDs September 2009 (Revised May 2010 & Aug 2011)  - 4 -  REFERENCES:    (1)  Sutherland I, Sivarajasingham V, Shepherd J. Recording of community violence by medical and police services. Injury Prevention 2002; 8:246-247.  (2)  Faergemann C, Lauritsen JM, Brink O, Stovring H. The epidemiology of repeat contacts with an Emergency Department or an Institute of Forensic Medicine due to violent victimization in a Danish urban population. Journal of Forensic and Legal Medicine 2007; 14(6):333-339.  (3)  Warburton AL, Shepherd JP. Development, utilisation, and importance of accident and emergency department derived assault data in violence management. Emerg Med J 2004; 21(4):473-477.   Information Sharing to Reduce Community Violence in EDs September 2009 (Revised May 2010 & Aug 2011)  - 5 - Contributing Authors Adrian Boyle, Consultant Emergency Physician, Cambridge  Jonathon Shepherd, Professor of Maxillo-facial surgery, Cardiff  David Sheehan, Department of Health, Guildford  Review The Clinical Effectiveness Committee approved this guideline in 2009. It has been revised and updated in May 2010 and August 2011. It will be reviewed in September 2012 or sooner if important evidence becomes available.    Disclaimers The College recognises that patients, their situations, Emergency Departments and staff all vary. This guideline cannot cover all possible scenarios. The ultimate responsibility for the interpretation and application of this guideline, the use of current information and a patient’s overall care and wellbeing resides with the treating clinician.  Research Recommendations None identified.  Audit standards Completeness of location recording should be 70% of assault cases.   Key words for search Violence, assault, information sharing.Information Sharing to Reduce Community Violence in EDs September 2009 (Revised May 2010 & Aug 2011)  - 6 - Appendix 1   Methodology Where possible, appropriate evidence has been sought and appraised using standard appraisal methods. High quality evidence is not always available to inform recommendations. Best Practice Guidelines rely heavily on the consensus of senior emergency physicians and invited experts.   Evidence Levels  1. Evidence from at least one systematic review of multiple well designed randomised control trials  2. Evidence from at least one published properly designed randomised control trials of appropriate size and setting  3. Evidence from well designed trials without randomisation, single group pre/post, cohort, time series or matched case control studies  4. Evidence from well designed non experimental studies from more than one centre or research group  5. Opinions, respected authority, clinical evidence, descriptive studies or consensus reports.  Information Sharing to Reduce Community Violence in EDs September 2009 (Revised May 2010 & Aug 2011)  - 7 - Appendix 2  Specimen data output Arrival Date Arrival Time Incident Location Incident Date Incident Time Weapon 01/03/2009 04:34 WHITE HORSE 01-Mar-09 05:04 Knife 01/03/2009 11:44 WHITE HORSE 01-Mar-09 15:00 Gun 02/03/2009 05:27 WHITE HORSE 02-Mar-09 08:12 Bottle 02/03/2009 13:18 REGENT STREET 02-Mar-09 17:05 Fist 02/03/2009 14:35 OXYGEN NIGHTCLUB 02-Mar-09 17:09 Feet 02/03/2009 18:11 RED LION PUB 02-Mar-09 19:06 Club 03/03/2009 19:26 OUTSIDE OXYGEN NIGHTCLUB  03-Feb-09 23:09 Fist 03/03/2009 21:55 REGENT STREET 03-Mar-09 22:45 Fist 05/03/2009 05:18 HOME 05-Mar-09 08:18 Axe      

Guideline for information sharing to reduce community violence

https://orca.cardiff.ac.uk/id/eprint/69081/1/CEM4881-CEC-Guideline-Information-sharing-to-reduce-Community-Violence-Sep-2009-%28Revised-Aug-2011%29.pdf

Guideline for information sharing to reduce community violence

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