Program to become part of nationwide injury free coalition for kids

December 28, 2001

Worcester, Mass. - The University of Massachusetts Medical School and UMass Memorial Children's Medical Center have been awarded a prestigious five-year Robert Wood Johnson Foundation grant to become part of the Injury Free Coalition for Kids, a nationwide organization of hospital-based injury prevention programs aimed at reducing the number and severity of childhood injuries.

"Injury is the leading cause of childhood morbidity, hospital admissions, and mortality in the United States," said Michael P. Hirsh, MD, professor of surgery and pediatrics at the University of Massachusetts Medical School. "With the generous support of the Robert Wood Johnson Foundation, the Injury Free Coalition for Kids of Worcester at UMass will provide the health care expertise and resources to kids in Worcester to help reduce the numbers associated with this public health problem," added Dr. Hirsh, who also serves as Chief of the Division of Pediatric Surgery and Trauma and is associate director of the pediatric intensive care unit at UMass Memorial Children's Medical Center.

Every year in the city, hundreds of children under age 19 are injured seriously enough to require medical treatment. In 1999 more than 500 kids were hospitalized with injuries caused by car or bicycle accidents, sports injuries, falls, poisonings, and assaults.

"In Worcester we already have in place a vast number of connections to appropriate agencies in the city and, more importantly, we have connections to the kids. The Foundation immediately recognized that this was an excellent opportunity to have a positive impact for kids," said Hirsh, who also cited the expansive reach of UMass Memorial's affiliated community hospitals and physicians as additional factors in winning the five-year, $265,900 grant.

The Injury Free Coalition for Kids was founded at the Harlem Hospital division of Columbia University in New York in 1981 by Barbara Barlow, MD, to address the high rate of serious injury to children in Harlem. Funded by the Robert Wood Johnson Foundation, the program seeks to prevent injuries by providing education to parents and caregivers about health hazards, eliminating dangers in the community and providing kids with free or low-cost social activities with strong adult role models. Barlow formed a coalition of pediatricians, pediatric surgeons, city and state agencies, local foundations, community organizations and parents. The program has shown marked success: since 1988 major injuries requiring hospital admission have decreased by 55% for kids living in central Harlem. (Of note, violent injuries have decreased by 46% for kids in central Harlem, despite nearly doubling in the neighboring community.) The Coalition currently has sites in New York (two sites), Hartford, Philadelphia, Pittsburgh (two sites), Chicago, Cincinnati, Kansas City, St. Louis, Atlanta, Miami, Los Angeles, and San Diego, all supported by the Foundation. Worcester is the fifteenth site.

When Hirsh joined the faculty of UMass Medical School and UMass Memorial in September 2000, he arrived with the experience of having set up the Injury Free Coalition for Kids program at two other hospitals. In 1994 he replicated the Harlem project at Allegheny General Hospital in Pittsburgh; when he moved to Mercy Hospital in Pittsburgh in 1997, the program went with him.

At UMass Memorial, Hirsh has brought together a broad array of city and state agencies to implement the Injury Free Worcester program as part of the Injury Free Coalition for Kids, including the Worcester Police and Fire Departments, the Governor's Highway Safety Bureau, Prevent Injury Now Network, the Mass Bike Coalition/Worcester Earn-A-Bike, the Black FBI (Fighting Back with Intelligence), Mass Brain Injury Association, Mass Prevention Center, the Office of the District Attorney/Middle District, the WIC (Women, Infants and Children) Program, Family Ties, Pediatric Trauma Nurse Consortium, Worcester Junior League, Belmont Community School, Shrewsbury Children's Center, ENCARE (Emergency Nurses Cancel Alcohol-Related Emergencies) and the Massachusetts State Police. Various internal UMass Memorial departments also will play a key role, including the Trauma Injury Prevention Program, Social Services, Emergency Medicine, Life Flight and EMS (Emergency Medical Services) and Pediatric Surgery/Trauma.

The program will enhance the existing UMass Memorial Pediatric Injury Prevention Program, established by Trauma Injury Prevention Coordinator Sharon A. Welsh, RN. "The expanded programs that this new grant empowers us to offer will help inoculate our region's children from injury, which has proven over time to be the number one killer of kids across the US," said Welsh.

Hirsh's team and the Children's Medical Center development office expect to work together to secure additional sponsors to participate in the Injury Free Coalition for Kids on a matching-gift basis. "The UMass Memorial Foundation will be helpful in pursuing additional financial support from Worcester area companies or civic organizations. "Increased funding means we can expand the scope and breadth to bring pediatric injury prevention education far into the community," Hirsh said. "We already have a number of ideas for how we can tailor the program to fit the needs of the kids in this city."

Other long-range plans include:
1) Safety Street, a life-sized model of a city street that teaches safe practices. The model Dr. Hirsh set up in the Pittsburgh program, based in part on a similar model in Harlem, includes a real bus, cars, bicycles, and storefronts and teaches kids not only to be aware of vehicles and other pedestrians, but also to be street smart and know how to react in different potentially dangerous situations. The city of Harlem now mandates yearly visits by all sixth graders. "We'd love to set up Safety Street in Worcester," says Dr. Hirsh, "but we have to take into consideration the logistics of getting kids to and from, the expense, the space available. We may look into a mobile version, where we can bring the street model to the schools" similar to the UMass Memorial Ronald McDonald Care Mobile that provides health can dental care throughout Worcester.

2) Mentoring Program. "We called it the Health Rangers in Pittsburgh," says Dr. Hirsh. "We connected mentors in the affiliated hospitals with middle schoolers considered to be at risk. The mentors were from all levels in the hospitals-not just doctors or nurses, but administrators, ambulance drivers, janitors, you name it-and it showed kids that it takes a team of people with different skills and different levels of education to make the hospital work. It showed that everyone was important."

3) Safe Playground. "I've been amazed at the number of injuries coming from the Bell Hill area, and they seem to stem partly from the lack of organized play space. We'd ultimately like to construct a playground for the area kids. Kids are much more likely to sustain injuries when they don't have a safe place to play."

4) Safe at Home project. Similar to the Safety Street model, the project would center on a miniature home to demonstrate common household hazards, plus a Safe At Home kit Dr. Hirsh designed in Pittsburgh that is now distributed nationally by Allstate Insurance. Kits include a home safety checklist, tips on making your home more child-friendly, and first-aid items. The Robert Wood Johnson Foundation, based in Princeton, NJ, is the nation's largest philanthropy devoted exclusively to health and health care. The Foundation concentrates its grant-making in three goal areas: to assure that all Americans have access to basic health care at reasonable cost; to improve care and support for people with chronic health conditions; and to reduce the personal, social and economic harm caused by substance abuse-tobacco, alcohol and illicit drugs.

University of Massachusetts Medical School, comprises the Graduate School of Nursing and the Graduate School of Biomedical Sciences as well as the School of Medicine, and has consistently ranked among the top medical schools in the country for primary care. One of the fastest growing academic health centers in the country, UMMS attracts more than $123 million in research funding annually. It's clinical partner, UMass Memorial Health Care, is central Massachusetts' largest not-for-profit health care delivery system, covering the complete health care continuum with teaching hospitals, affiliated community hospitals, free-standing primary care practices, ambulatory outpatient clinics, long-term care facilities, home health agencies, hospice programs, a rehabilitation group and mental health services.