IVYY Project — Atlanta (Grady Memorial / Emory)

City Profile: Atlanta, Georgia

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IVYY Project — Interrupting Violence in Youth and Young Adults

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Grady Memorial Hospital / Emory University School of Medicine

Program type: Hospital-based violence intervention program

Institutional home: Grady Memorial Hospital (Level 1 Trauma Center),

operated through Emory University School of Medicine Department of

Surgery

Launch date: January 2023

Target population: Gunshot and penetrating trauma victims, ages

14–34

Model: Bedside-Clinic-Community (three-phase continuum of care)

Medical director: Dr. Randi N. Smith, MD, MPH, trauma surgeon and

Associate Professor, Emory University School of Medicine

The Problem That Built the Program

Atlanta’s Grady Memorial Hospital is the city’s only Level 1 Trauma

Center — the single institution absorbing the full volume of the

city’s most severe gunshot wounds. The number of trauma patients

admitted because of violent crimes increased 50% at Grady between May

2020 and the program’s 2023 launch. Trauma surgeons worked that volume

daily. They also watched the same patients return.

Dr. Smith, who had joined Emory’s Violence Prevention Task Force in

2017, described what drove her to build something beyond the operating

room: “Every day, I would see patients coming in through our trauma bay

injured by violence, and I knew I wanted to be part of the solution. I

wanted to figure out what was bringing them here in the first place and

prevent them from coming back.”^[1]

Dr. Kirsten Bechtel at Yale has documented that assault victims “are

much more likely to be involved in a homicide or an assault with a

firearm in the next six months.”^[2] Dr. Michel Aboutanos at VCU

Medical Center has cited national gunshot wound recidivism at “almost

up to 50%, if not a little bit higher.”^[3]

Program Design: The Bedside-Clinic-Community Model

The IVYY Project operates on a structured “Bedside, Clinic, Community”

continuum developed by the program’s clinical team and described in a

paper published in Trauma Surgery & Acute Care Open in 2025. The model

extends the intervention in three phases beyond the acute trauma

response:

Phase 1 — Bedside: Violence intervention specialists arrive at the

patient’s hospital bedside during the acute treatment phase, providing

“immediate care to victims of violence at the time of injury” and

ensuring they receive “medical treatment and psychological support”

simultaneously. The goal at this phase is establishing the relationship,

the connection with a credible messenger that will carry the

intervention into discharge and beyond. Specialists are deployed through

a trauma pager system so they can be notified immediately when an

injured patient arrives. The program uses credible messengers: trained

staff with lived experience of the same communities and, often, the same

violence cycles their patients are navigating.^[4]

Phase 2 — Clinic: A multidisciplinary “clinic” component

operates as what the program describes as a “one-stop shop” combining

ongoing medical care beyond the acute treatment phase with social

services under one roof. The clinic team includes “physicians, advanced

practice providers, wound care specialists, mental health experts, a

social worker,” providing a “critical bridge between immediate bedside

care and long-term community resources.” This phase addresses the

period when most programs lose patients: after hospital discharge,

before the patient has stabilized in the community.^[5]

Phase 3 — Community: The program’s community partnership network

connects patients to organizations providing ongoing wraparound support

across five domains: mental health services, education, employment,

financial assistance, and legal aid, as well as housing, transportation,

and food security programs. The warm handoff from clinic to community

partner is active, not passive: the program does not provide a referral

list, it makes the connections.^[6]

Who the Specialists Are

IVYY deploys what the program calls “credible messengers” —

specialists whose first qualification is lived experience with violence,

incarceration, or the same neighborhoods and street networks the

patients come from.^[7]

Dr. Smith describes the model: the program “provides critical support

for gun violence victims ages 14 to 34 by employing a

bedside-clinic-community model.” The goal is not only preventing

reinjury but addressing the conditions that make reinjury likely. “In

lots of places, people are just patched up and sent right back out into

the neighborhoods and circumstances that led to the injuries in the

first place,” Smith said. “We are understanding the root causes and

are focused on addressing those social drivers of health that impact how

patients do when they leave the hospital.”^[8]

The University of Chicago’s Violence Recovery Program, which provided

guidance and training when IVYY launched, employs a similar workforce

model. Dwayne Johnson, the UChicago program’s director, described the

training provided to the Grady team as intensive and ongoing: “This

wasn’t a one-off training. Our goal is to have our model duplicated

throughout the nation. This program is life-changing, and other

institutions see that.”^[9]

What the Program Does at Bedside

When a patient arrives at Grady with a gunshot wound or stabbing injury,

the trauma pager activates. A IVYY specialist goes to the bedside while

the patient is receiving medical treatment. The initial contact

accomplishes several things simultaneously:

• Immediate emotional support and safety assessment

• Safety planning for discharge — addressing specific threats,

active conflicts, or dangerous living situations

• Assessment of the patient’s immediate social needs: food security,

housing stability, financial situation

• Introduction to the program and the relationship that will continue

after discharge

• Warm connection to community organizations that can begin wrapping

services around the patient before they leave the hospital

young patients ages 14–24 who arrive at Grady after gun violence are

dealing with food insecurity, housing instability, and financial crisis

simultaneously, according to program data from Dr. Smith.^[10]

Outcomes

The IVYY Project reports outcomes through both institutional

announcements and peer-reviewed literature.

Reinjury rate: In the program’s second year, Emory University

School of Medicine announced that “less than two percent of patients

treated in coordination with the IVYY Project have returned with a

gunshot wound — a reinjury rate far below the national standard of

30-40 percent.”^[11] Earlier reporting from the program’s first year

showed 1% reinjury in the initial participant cohort, with “less than

3% of participants have come back into the hospital with a violent

injury.”^[12]

Patient reach: In its first two years, IVYY physicians worked with

“more than 650 participants and their families, providing food, housing

assistance, and mental health support.”^[13]

Published research: A 2025 paper in *Trauma Surgery & Acute Care

Open* by members of the IVYY clinical team (including Castater, Hart,

Metchik, Jackson, Wright, Cave, Alexander, Clemons, Sarumi, and Smith)

formally described the Bedside, Clinic, Community model as a replicable

framework for hospital-based violence intervention. A companion paper in

Surgery (2026) co-authored by Smith and colleagues addressed

“coalition building for regional violence prevention advocacy.”^[14]

Institutional investment: In 2023, the Arthur M. Blank Family

Foundation made a $25 million investment to expand Grady’s violence

prevention work more broadly, in recognition of the IVYY program’s

results.^[15] Dr. Smith also received a $2 million Department of

Justice grant through the Community Violence Intervention and Prevention

Initiative (CVIPI) for the IVYY program’s work.^[16]

Evidence limits: The 2% reinjury figure is program-reported data

from one institution. It is not independently verified through a

controlled study. Indianapolis, Minneapolis, and Virginia HVIPs report

reinjury rates in the same 3–4% range. Long-term outcomes beyond two

years have not yet been documented.

The DOJ Grant and National Recognition

Dr. Smith’s $2 million DOJ award from the Office of Justice Programs

CVIPI recognized IVYY’s approach to treating “violence as a public

health crisis, rather than a public safety issue.”^[17] When IVYY

launched in January 2023, the UChicago VRP team provided multi-day

guidance and training.^[18]

Context: Atlanta’s Violence Prevention Ecosystem

The IVYY Project operates within a broader Atlanta violence prevention

ecosystem that includes both hospital-based and community-based CVI

work. Dr. Smith and colleagues have published on “coalition building

for regional violence prevention advocacy” and “violence prevention

advocacy in surgery: strategies across the socioecological spectrum”

— indicating the program’s intentional placement within, rather than

apart from, the city’s larger violence reduction infrastructure.^[19]

Grady’s trauma volume increased 50% between May 2020 and the program’s

2023 launch. The Level 1 Trauma Center designation means the hospital

absorbs the region’s most severe cases. Emory’s research

infrastructure has allowed the team to publish, evaluate, and

disseminate the model.^[20]

What Other Cities Have Learned from IVYY

The Bedside-Clinic-Community framework published by the IVYY team

represents the program’s explicit attempt to create a replicable model

rather than a locally specific solution. The three-phase structure

(bedside crisis intervention, multidisciplinary clinic follow-up,

community partnership network) is designed to be translatable to other

Level 1 Trauma Centers with different staffing models, community

contexts, and organizational configurations.

Dr. Smith has described pager-based activation, credible messenger

staffing, and the clinic bridge between discharge and community

connection as the model’s core structural elements.^[21]

Footnotes

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^[1]: Dr. Randi N. Smith, MD, MPH. Quote on clinical motivation: “Every

day, I would see patients coming in through our trauma bay injured

by violence, and I knew I wanted to be part of the solution.”

Source: 11Alive (NBC Atlanta), “Grady Hospital breaks cycle of

violence with intervention program.” Dr. Smith joined Emory

Violence Prevention Task Force in 2017 per Emory 2023 news

highlights.

^[2]: Dr. Kirsten Bechtel, physician and professor of pediatrics, Yale

School of Medicine. Six-month reinjury risk. WTNH reporting.

^[3]: Dr. Michel Aboutanos, Level 1 trauma surgeon, VCU Medical Center,

Richmond, VA; NBC12 Richmond reporting. Six-month reinjury risk

data. Source: WTNH reporting; HVIP newsletter source material.

^[4]: Bedside-Clinic-Community model. Source: “Characteristics of a

three-pronged continuum of care model for hospital-based violence

intervention.” Castater C, Hart L, Metchik A, Jackson K, Wright R,

Cave N, Alexander C, Clemons J, Sarumi P, Smith RN. *Trauma Surgery

& Acute Care Open.* 2025;10(4):e001869. PMID: 41333681. Also Emory

University School of Medicine IVYY Project page.

^[5]: IVYY clinic component: “one-stop shop,” “critical bridge

between immediate bedside care and long-term community resources.”

Source: 11Alive/Alive 11 coverage; IVYY paper (Castater et al.,

2025).

^[6]: IVYY community partnership network: mental health services,

education, employment, financial aid, legal aid, housing,

transportation, food security. Source: IVYY paper (Castater et al.,

2025); Emory IVYY Project page.

^[7]: Bedside-Clinic-Community model. Source: “Characteristics of a

three-pronged continuum of care model for hospital-based violence

intervention.” Castater C, Hart L, Metchik A, Jackson K, Wright R,

Cave N, Alexander C, Clemons J, Sarumi P, Smith RN. *Trauma Surgery

& Acute Care Open.* 2025;10(4):e001869. PMID: 41333681. Also Emory

University School of Medicine IVYY Project page.

^[8]: Dr. Randi N. Smith: “bedside-clinic-community model,”

“understanding the root causes,” “social drivers of health.”

Source: 11Alive coverage; Alive 11 report (Aisha Howard, Akilah

Winters, Gabriella Nunez, Darrell Pryor).

^[9]: Dwayne Johnson, Director, Violence Recovery Program, University of

Chicago Medicine. Training relationship with Grady: “This wasn’t a

one-off training. Our goal is to have our model duplicated

throughout the nation.” Source: UChicago Medicine press

release/civic engagement site. Note: Johnson was named VRP Director

in 2024 per UChicago Medicine Trauma Resiliency page.

^[10]: Patient demographics — two-thirds of 14-to-24-year-old gunshot

victims facing food insecurity, housing instability, financial

crisis. Source: Dr. Randi Smith, quoted in WXIA/NBC Atlanta

reporting.

^[11]: Emory University School of Medicine IVYY announcement: “less

than two percent of patients treated in coordination with the IVYY

Project have returned with a gunshot wound — a reinjury rate far

below the national standard of 30-40 percent.” Source: Emory

University School of Medicine IVYY Project page.

^[12]: Earlier IVYY reinjury data: “1 percent of participants have been

reinjured in the past year” (first year, Alive 11 reporting, Liza

Lucas); “less than 3% of participants have come back into the

hospital with a violent injury” (second year, Alive 11, Aisha

Howard et al.).

^[13]: “More than 650 participants and their families” in IVYY’s

first two years. Source: 11Alive/Alive 11 reporting on IVYY two-year

report.

^[14]: Published research. Castater et al. 2025 paper in *Trauma Surgery

& Acute Care Open*, PMID 41333681. Smith RN, Ward C, Hink A, Hannah

A, Mbaka MI, Williams A, Castater C. “Violence prevention advocacy

in surgery: strategies across the socioecological spectrum.”

Surgery. 2026. PMID: 41151489. Hannah A, Russo K, Ward C, Mbaka

MI, Williams A, Hink A, Kutcher M, Hodge J, Clemons J, Castater C,

Smith RN. “Coalition building for regional violence prevention

advocacy.” Surgery. 2026. PMID: 41172885.

^[15]: Arthur M. Blank Family Foundation $25 million investment in

Grady violence prevention work. Source: Dr. Randi Smith LinkedIn

post referenced in Grady Health profile.

^[16]: Dr. Randi N. Smith, $2 million DOJ CVIPI grant. Source: Emory

University School of Medicine 2023 News Highlights, “Randi Smith

named recipient of DOJ Grant Award.”

^[17]: DOJ CVIPI recognition of IVYY for “treating violence as a public

health crisis, rather than a public safety issue.” Source: Emory

University School of Medicine DOJ grant announcement (2023).

^[18]: Dwayne Johnson, Director, Violence Recovery Program, University

of Chicago Medicine. Training relationship with Grady: “This

wasn’t a one-off training. Our goal is to have our model duplicated

throughout the nation.” Source: UChicago Medicine press

release/civic engagement site. Note: Johnson was named VRP Director

in 2024 per UChicago Medicine Trauma Resiliency page.

^[19]: Dr. Smith’s coalition-building publications: “Coalition

building for regional violence prevention advocacy” (Surgery, 2026)

and “Violence prevention advocacy in surgery: strategies across the

socioecological spectrum” (Surgery, 2026). PMIDs: 41172885,

^[21]: Bedside-Clinic-Community model. Source: “Characteristics of a

three-pronged continuum of care model for hospital-based violence

intervention.” Castater C, Hart L, Metchik A, Jackson K, Wright R,

Cave N, Alexander C, Clemons J, Sarumi P, Smith RN. *Trauma Surgery

& Acute Care Open.* 2025;10(4):e001869. PMID: 41333681. Also Emory

University School of Medicine IVYY Project page.