Northwell Health adding query about guns to ER patient screenings

Starting later this month, Northwell staff at two Long Island hospitals and a third on Staten Island will add a question to their routine screening of emergency room patients: Do you have a gun in your house?

The question is part of a new screening program designed to analyze patients' risk for firearm injury.

The program will be funded under a $1.4 million grant from the National Institutes of Health that Northwell received to study gun violence prevention.

The New Hyde Park-based health system said the grant is part of its "We Ask Everyone. Firearm Safety is a Health Issue" research study, which approaches firearm injury risk similarly to other health risk factors that are part of routine care, like smoking, substance use and motor vehicle accidents.

"Gun violence is a public health issue," said Michael J. Dowling, president and chief executive at Northwell Health. "This is the health industry's responsibility to talk about this and do something about it."

The study will initially establish evidence-based screening and intervention strategies within three of Northwell's hospitals: Cohen Children's Medical Center in New Hyde Park, South Shore University Hospital in Bay Shore, and Staten Island University Hospital. South Shore changed its name from Southside Hospital this month.

The three locations were selected because they support regions with critical need for firearm injury and mortality prevention, and areas with at-risk youth, the health system said.

Northwell said that, in time, it plans to expand the program systemwide.

The study will launch later this month, said Dr. Chethan Sathya, director of Northwell's Center for Gun Violence Prevention. Northwell opened the center in February in an effort to spur national debate on the need for health care leaders to help curtail the nearly 40,000 firearms-related deaths that occur every year in the United States.

As part of the Northwell study, clinicians in the three hospitals' emergency departments will ask patients specific questions about having firearms in their homes and determine their risk of injury. Each response is scored and embedded into the patient’s electronic health record, which will help guide discussions and establish next steps for care. Motivational interviews, education and other resources will also be available.

The study follows a similar protocol as the health system’s Screening, Brief Intervention and Referral to Treatment, or SBIRT, a program implemented in Northwell emergency departments several years ago to identify substance misuse and connect patients to treatment. Through SBIRT, Northwell has completed 1.5 million patient screenings across 18 emergency departments and many inpatient and outpatient settings, resulting in 23,000 brief interventions and 8,000 referrals.

Northwell's NIH grant comes as gun violence remains the leading cause of premature death in the United States, according to the Centers for Disease Control and Prevention.

"We've seen a significantly higher number of firearm injuries compared to last year," Sathya said. "We don't know how many people have guns in the household, and we don't know how many children may have improper access. This is a chance to understand the underlying issues, and counsel on gun safety."

Sathya added that the grant will "fully support We Ask Everyone. Firearm Safety is a Health Issue and allow us to expand upon the limited clinical studies that have primarily focused on outpatient settings or used targeted vs. universal screening, which can exclude at-risk patients."

Also, Northwell said it plans to hold a virtual Gun Violence Prevention Forum on Dec. 10. The event could include victims, education leaders and health care professionals, Dowling said.

Northwell this year pledged $1 million toward stemming gun violence and launching the center.

"We've had overwhelming support from the employees at this health system," Dowling said. "Across the country, it varies, because some health systems are in states where they're wary of the politics of talking about guns."

Northwell Health is the largest health system and largest private employer in the state, with about 72,000 employees.