Mapping Case Management Activities to Support Implementation and Fidelity of a Pediatric Hospital-Based Violence Intervention Program

Abstract

Background: Hospital-based violence intervention programs (HVIPs) provide community-based case management to victims of violence and address recovery across a range of needs, including safety, medical, mental health, legal, and basic needs. Describing and standardizing program practices are essential in supporting victim service program replication and growth. Our aim was to explicate the discrete activities undertaken within a pediatric HVIP to support resolution of client needs. With this information, we developed visual goal maps, which can be used to enhance fidelity and delivery of evidence-informed HVIP case management services.

Methods: As part of a formative evaluation of a pediatric HVIP affiliated with a major urban Level I pediatric trauma center, we coded a retrospective sample of HVIP encounter notes (n = 2218) from a random sample of 67 former clients, stratified to ensure representation of a diversity of client demographics and needs. Program activities, resources, outputs, and outcomes were identified using a structured coding schema. Using a directed content analysis approach, we reviewed coded data to categorize discrete programmatic activities undertaken in support of clients’ recovery goals.

Results: We developed visual goal maps that illustrate common and exemplar activities HVIP case managers complete as they support clients in addressing recovery goals across 12 need domains. Maps illustrate common and exemplar activities HVIP staff complete as they support clients in addressing recovery goals across 12 need domains. Organizing the activities is used to achieve goals within need domains differentiated between case management services (e.g., obtain insurance information) and measurable recovery goals (e.g., provide mental health therapy).

Conclusions: These maps provide a user-friendly visualization to inform case management services to support client recovery. Within victim service programs, the maps may be useful tools to enhance training, guide care planning, support supervision, standardize program services, and ensure implementation fidelity.