How Is This Different?

The “Patch and Release” Model

Daniel Blum, chief executive of Sinai Hospital and Grace Medical Center in Baltimore, named the prior standard plainly: “patch and release.”¹ Dr. Ashley Williams Hogue, a trauma surgeon at USA Health University Hospital in Mobile, has described what that standard produces: she has “operated on the same victims who’ve been shot [and then shot again] in separate incidents.”²

HVIPs add a separate workforce to the trauma unit whose job begins where surgery ends.

What the Comparison Looks Like Concretely

The Indianapolis Prescription for Hope program at Eskenazi Hospital found that only about 3% of participants returned to the emergency department with a repeat violent injury within the first year, compared with 8.7% when the program was not operating. Thomas Stuckey, a former police officer and current professor of criminal justice at Indiana University-Purdue who analyzed the program, described this as “a two-thirds reduction in the likelihood that someone with a violent injury will need similar emergency medical assistance in the future.”³ The 8.7% figure is the same hospital’s own historical rate without the program.

Virginia’s statewide results show the same direction across 12 programs. The Virginia Hospital and Healthcare Association reports a 3% re-injury rate for HVIP patients statewide, against a national average of approximately 40%.⁴ Across the state, more than 8,000 violence victims served since 2019 have generated an estimated $82.5 million in health care costs avoided — the accumulated difference between what the medical system spent and what it would have spent had those patients returned with repeat injuries at the national rate.⁵

Dr. Michel Aboutanos, the Level 1 trauma surgeon at VCU Medical Center whose program became the template for Virginia’s statewide network, describes the national baseline against which that comparison runs: gunshot wound recidivism nationally is “almost up to 50%, if not a little bit higher.” VCU’s five-year recidivism rate for enrolled patients: 3.6%.⁶

The Difference in Workforce

At Atlanta’s Grady Memorial Hospital, the IVYY Project employs what the program calls “credible messengers” — trained experts who live in the community and often have lived experience with violence themselves.⁷ Nkosi Cave, a violence intervention specialist at the IVYY Project, describes the dynamic: “When we meet people at the bedside, we kind of see a reflection of ourselves and our communities in our patients. A lot of times, we’re meeting people that we might’ve known in the community.”⁸

The University of Chicago Violence Recovery Program employs around 20 violence recovery specialists working around the clock, alongside licensed social workers and clinical staff.⁹ Christine Goggins, the program’s lead violence recovery specialist, holds a social work license and co-developed the training curriculum that UChicago now exports to other hospitals — a hybrid that combines community credibility with professional infrastructure.¹⁰

Prisma Health in Columbia, South Carolina fields a team that combines trauma surgeons, internal medicine, psychiatry, injury prevention specialists, and university researchers.¹¹ Dr. Lindsey Dunkelberger, the Prisma Health trauma surgeon who leads the program, has described what that team structure enables at the bedside: as physicians “treat physical wounds, survivors become open to interventions to break the cycle of violence.”¹²

The Difference in Duration

Dr. Amy Makley of Cincinnati describes the shift: “Instead of helping the victim for a day or two treating their physical wounds, the support will continue for months after leaving the hospital.”¹³ The sustained engagement model from Minneapolis’s Next Step provides “ongoing trauma counseling, as well as legal services, work placement, or school enrollment assistance” long after discharge.¹⁴

Boston Medical Center’s Violence Intervention Advocacy Program found in a study published in the Annals of Internal Medicine in January 2026 that sustained engagement — initiating within one month of injury and engaging more than four of the first eight weeks post-hospitalization — was associated with risk reductions exceeding 55% at three-year follow-up, compared to outcomes that were “roughly equal between treatment and control” for briefer engagement. The researchers concluded that HVIP effects “seem to require intensive participant engagement.”¹⁵

The Difference in Measurement

The IVYY Project at Grady Memorial Hospital measures reinjury rates, program participation, and social stabilization outcomes. VCU Medical Center tracks five-year recidivism. The University of Chicago program monitors connection to community agencies, employment, and educational engagement. A review of HVIP research found that 89% of program graduates either obtained employment, received a diploma, or completed general educational development.¹⁶

Louisville’s Office of Violence Prevention publishes an annual report with specific patient numbers, enrollment rates, and citywide violence data. The October 2025 report documented 628 patients presenting with qualifying injuries, an 85% enrollment rate, and a 62% decline in gun violence in the four Pivot to Peace target neighborhoods in the first half of 2025 compared to the same period over the prior four years.¹⁷ These are outcomes that traditional trauma care tracking — survival, complications, readmission for medical reasons — does not capture and would not have surfaced.

The Difference in Institutional Positioning

The Grady Hospital program provides not a referral but “a warm handoff” to community-based groups.¹⁸ The University of Chicago connects patients to more than 60 community-based social and behavioral health agencies.¹⁹ Dwayne Johnson, the VRP’s director, has described the mission as having “our model duplicated throughout the nation” because “this program is life-changing, and other institutions see that.”²⁰

Virginia’s state-level investment illustrates what institutional commitment at scale produces. Starting from Dr. Aboutanos’s single program at VCU, the state built a 12-hospital network through sustained funding and a shared training infrastructure. The Virginia Hospital and Healthcare Association now oversees that network and reports collectively on its outcomes. That organizational layer — a statewide hospital association taking ownership of HVIP results and advocating publicly for the funding — does not exist in most states.²¹

What Has Not Changed

Dr. Smith at Grady describes this as a “bedside-clinic-community” model with three distinct phases, not a single intervention that replaces what came before.²² HVIPs work alongside the clinical team; they do not replace it.

The University of Chicago maintains roughly 20 violence recovery specialists working around the clock — the staffing level required for a Level 1 Trauma Center with high gunshot volume. Most programs have not approached that scale.²³