Presenter Profile
Jennifer E. McCain, MD
University of Alabama at Birmingham
Medical Director: Children’s of Alabama Health Education and Safety Center
jennifermccain@uabmc.edu
Jennifer E. McCain, MD is an Assistant Professor of Pediatrics at UAB where she is a board certified Pediatric Emergency Medicine physician in the Children’s of Alabama Emergency Department. She has been the representative from District 3 (the counties directly surrounding Birmingham) to the board of the Alabama Chapter of the AAP for the last eight years and is a voting member of COPEM (Committee on Pediatric Emergency Medicine) with the national AAP. After 12 years as a general pediatrician, she returned to this academic position where she actively cares for patients in the ED, participates in education of residents and students, and participates in research. Dr. McCain has a specific interest in injury prevention. She has been actively involved in developing relationships in urban Birmingham as well as in rural Alabama counties to address safe sleep for infants. Additionally, she has been working with groups through the Alabama Chapter of the AAP as well as with leaders at Children’s of Alabama to advocate for firearm injury prevention.
Presentations
Creation of a Multidisciplinary Team to Combat Firearm Injuries
Jennifer E. McCain, MD
Michele Nichols, MD
Lisa Maloney, MSN, RN
Cursey Sitzler, MSN, CRNP
Jamie Smelcer, MSN, RN
Kathy Monroe, MD, MSQI
Firearm-related injuries have become the leading cause of death in children. Over the last five years at our children’s hospital, annual ED visits for children with firearm-related injuries increased by 141% (41 in 2018 to 99 in 2023). Recognizing this alarming trend, a firearm injury prevention team began meeting in August 2023 to find ways to address this multifaceted problem.
With support from hospital administration, a multidisciplinary team was developed by Emergency Department (ED) leaders with funding from the hospital foundation and corporate communications. Teams included representatives from the Emergency Department, Integrative Care, Government Relations, Communications, and Mental Health. Physicians were also present from Rehabilitation Medicine, ED, Hospital Medicine, and Critical Care. Many were already addressing firearm injury prevention individually.
The goal of the team, which meets bimonthly, is to slow the rising trend at our hospital of firearm-related injuries. The initial action was to improve awareness of hospital staff of the significant increase in firearm-related injuries. The next goal was to encourage community pediatricians to engage in discussions during patient encounters regarding securing all firearms. A needs assessment tool was administered to hospital-affiliated general pediatricians to gauge the culture of firearm discussions during visits, measure interest in further education, and provide firearm locks to patients.
Data demonstrating the rise of firearm injuries over the last 20 years was shared with hospital administration and campus leaders. Three podcasts offered multiple communications and discussions. A state House Representative met with the team to discuss upcoming legislation. Team members working with pediatric residents in Health Equity Scholars shared BeSMART educational materials and resources at community meetings. Team members participated in our local chapter’s National Injury Prevention Day along with other community events.
The team developed a pathway to screen all ED and surgical ward patients for the presence of unsecured firearms within the patient’s home. The care team provides cable gun lock(s) and educational materials to families with unsecured firearms. A hospital violence intervention program is being developed by the team which is also providing wraparound services for patients in anticipation of hospital discharge.
Of the 78 community physicians contacted for the needs assessment, 60 (78%) responded. Regarding whether firearms discussions occur, 33/51 (64.9%) reported they discussed firearms only with certain at risk populations or not at all. Most of the physicians (80%) were interested in further education about having these discussions. Based on this needs assessment, the team is partnering with four practices to offer guidance regarding secure firearm education and gun locks for their patients’ families.
The creation of a firearm injury prevention team allowed disparate groups to work together instead of in silos. Bringing stakeholders together was a logistic challenge. Once the team convened, though, efforts were coordinated and combined. We believe this team has made significant progress toward combatting this serious concern.
1. Firearm injuries are increasing significantly in the last 5 years.
2. Community pediatricians are interested in learning how to provide firearm injury prevention in their clinics.
3. Multidisciplinary teams can make much more progress than individuals working on their own to address injury prevention.