Quality Improvement Assessment of a State-Funded Reporting and Intervention System for Youth Firearm Injury: Pennsylvania Injury Reporting and Intervention System (PIRIS)

Background/Purpose: Firearm injury is the second leading cause of death among youth. In 2006, the Pennsylvania Department of Health launched the Pennsylvania Injury Reporting and Intervention System (PIRIS) that integrates injury surveillance with a case management intervention to aid recovery of 15-24 year-old gunshot patients and reduce youth violence. This report presents results of a program quality improvement assessment. Methods: PIRIS MIS data for 88 discharged participants enrolled over 18 months were grouped into six cohorts and into groups of participants enrolled in 2006 or in 2007. Chi-square/ANOVA statistics were used to examine changes over time in their outcomes measured at discharge.. Results: Enrollment Cohorts were similar in terms of age, gender, race, and education employment and legal status at program intake. Participants enrolled earlier in the program were at increased risk for violence recidivism; identified fewer goals; were more likely to identify education and mental health goals; stayed in the program longer; had fewer in-person Case Manager contacts; more likely discharged due to not meeting goals; and less likely to have been discharged because they could no longer be engaged in the program. Conclusions: Case Managers learned to adapt to changes in the challenges they face engaging new participants in the program. Because participants who identify more goals are more difficult to engage in the program, Case Managers should help participants identify their most important goals and help them work toward meeting those goals as soon as possible after they enter the program.