Integrating Injury Prevention Efforts into Health Care Delivery

One of the goals of injury prevention efforts should be the integration of injury prevention strategies, policies, and messages into existing programs of service delivery, routine activities of health professionals, and priority initiatives of professional associations. Such integration expands the population that can be reached and increases the likelihood of the institutionalization of injury prevention. For example, childhood injury prevention education can be incorporated into a variety of settings where families receive health and social services, including prenatal care clinics; primary health care settings; Women, Infants, and Children clinics; and parenting classes.

Inasmuch as the costs of providing treatment for injuries are often borne by the injured person's health insurance provider, there is the potential for considerable cost savings through the prevention or amelioration of injuries. Thus, injury prevention should be integrated into the clinical care and prevention programs of managed care organizations. Opportunities include collecting and analyzing their own data on injuries using E-codes; using hospital community benefits programs (mandated in 12 states) to implement domestic violence programs; conducting screening and anticipatory guidance activities; providing patients with incentives for safe behaviors; and training providers on injury prevention issues.

There are many additional opportunities for integrating injury prevention into health care. These include the incorporation of developmentally appropriate injury prevention counseling into visits to pediatric and prenatal clinics, as well as home visits. Relevant professional organizations can embrace injury prevention as an integral component of practice and can issue guidelines and policy statements. Injury practitioners should provide their expertise to managed care organizations in order to facilitate the integration of injury prevention into managed care plans and practices. Federal agencies can foster integration by including injury prevention within existing service delivery, planning, and policy documents (e.g., block and training grant applications). For example, the MCHB has recently included youth suicide and motor vehicle crashes as 2 of 18 national maternal and child health performance measures that states must report annually (HRSA, 1997).

COLLABORATION AND COALITION BUILDING

One of the strengths of the injury prevention field is the broad base of stake-holders concerned about reducing injury morbidity and mortality. As discussed above, injury prevention is part of broader public safety efforts at the state and local levels, and numerous federal, state, and local agencies and organizations have a mandate to ensure public safety. Additionally, there are nonprofit organizations, for-profit corporations and businesses, and foundations that have the



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