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This review focuses on pitfalls and lessons learned during the development, implementation, and sustainability of hospital community-based youth violence prevention program. In the USA, homicide is the third leading cause of death among youth aged 10–24. The re-injury rate seen at Virginia Commonwealth University Trauma center (VCU-TR) is comparable to the nationally observed rate of 10 to 50%. VCU-TR, along with several other Trauma Centers, has taken an active role in the development of hospital community-based youth violence prevention programs. The efforts have been effective in reducing recidivism and the risks of violence. Significant pitfalls can be avoided in the development and sustainability of an evidence-based, collaborative, hospital community-based youth violence prevention programs. This review highlights the effectiveness of hospital community-based violence prevention programs in reducing the risks of re-injury. There are significant pitfalls to avoid both internal within the institution as well as external with the community partners.

Purpose Studies have shown that there is a current trend for many patients with dental problems to seek care in a hospital emergency department (ED). This may contribute to an already overcrowded and overburdened situation. The purpose of this study was to determine the volume and characteristics of the patients seeking care in the ED of a large metropolitan level I trauma center. Patients and Methods Using ICD-9 diagnosis codes for dental complaints, the following ED data were collected for the years 2007 through 2009: the number of patients, the age of patients, the day and time the patients presented, the number of visits patients made to the ED for a dental-related complaint, and the insurance status of the patients. This information was then used to develop a pilot program to divert these patients from the ED to a special Urgent Dental Care Clinic located in the hospital Oral and Maxillofacial Surgery Clinic, and data on number of patients treated in the following year were compared with the number treated in the ED the previous year. Results There were 173,648 emergency department visits between 2007 and 2009. Of these, 4.3% were dental-related. The majority of the patients presented between 7 am and 6 pm on Monday through Thursday, with the highest percentage on Monday. The insurance status showed that 39.7% had Medicaid or Medicare, 52.7% were uninsured, and only 7.6% had private insurance. Sixty-seven percent had tooth-related ailments. The treatment in most cases was limited to a prescription for pain medicine and an antibiotic. In the year prior to initiation of the pilot program there were 2,618 patients with dentally related problems managed in the ED. This decreased more than 52% during the first year of the pilot program. Return to the ED for a subsequent dental problem was also reduced by more than 66%. Conclusion A diversion plan for dental patients can be effective in reducing their impact on the busy ED.