Police-Medical collaboration

[Tom Hanna <tph3@xxxxxxxxxxx>]

Forgive multiple posts.  Forwarded at the request of the PERF/BJA 
Police-Medical
Collaboration Project
Please reply to:
Cliff Karchmer <mailto:ckarchmer@policeforum.org>
----------------------------------------------------------
Dear Colleague,

The following letter was sent to you regarding your interest,
recommendations or comments for the PERF/BJA Police-Medical
Collaboration Project.  Your input is extremely valuable to the
direction of this project.  Please send your response to PERF by Friday,
May 12, 2000 so that we can consider the suggestions and plan
accordingly.  Thanks for your time and cooperation on this vital matter.

Clifford Karchmer



The Police Executive Research Forum (PERF) is trying to build bridges
of professional collaboration and mutual information exchange between
law enforcement the various components of the medical community.  For
the purpose of this Justice Department project, that community
includes emergency and trauma physicians as well as nurses, EMS/EMT,
and counselors.

An attachment to this e-mail provides a brief overview of the project,
as well as were we are and where we hope to take the collaborations in
the next year.

A major project activity is a national summit of medical and related
experts who will convene in the coming months to draft protocols on
information exchange and discrete interventions, mainly of a
preventive nature, that may be expected to result.

In order for that summit to be as productive as possible, given the
short time for the event, we want to make sure that we cover the major
issues and then subject them to a "reality" test--i.e, of all the
possible collaborations, what are likely to be the most practical in
terms of the efficacy of particular interventions and the ability of
medical experts, working more closely with police, to identify the
most at-risk citizens and do what is legally and constitutionally
permissible to remove them from harm's way?

In order to identify the most vulnerable populations and the perils
they are most likely to suffer, we have prepared a brief set of
questions (below).  I ask that you take a few minutes to provide
information and then take some time with the last question and tell us
what you would like this project to focus on or should emphasize.

Of course, I am available to answer any questions you may have and
hope that you will contact me if you would like to learn more about
this project--or if you would like to remain in close touch with us as
the various project activities unfold.  I believe that we will
certainly enrich each other's professional understanding of these
issues if we do.

Very best regards,

Clifford L. Karchmer
Project Director
Police Executive Research Forum
Washington, DC

---




                                         Police-Medical Collaboration
Project:
     Questions to Help Structure the National Summit Meeting on Protocol
Development


1. Regarding injuries that may be intentionally caused but not
identified as such, what populations do you believe are most at risk
or perhaps what priority should we accord a specific age or other
group in comparison to others?

2.  What specific types of injuries have you found are most serious
for the particular age or other group(s) you identified in question 1?

3.  What types of interventions (preventive or otherwise) that do or
possibly could involve law enforcement, have you found to be effective
in dealing with the particular at-risk population and the injury
peril(s) to which you have found them most vulnerable? (please
elaborate or, if possible, alert us to public domain sources of
information on these interventions.)

4. What specific issues--medical, procedural (legal, etc) or
other--would you recommend this project emphasize in order to be of
most help to you in your work?

5.  What else would you like to tell us that is important for us to
know as we complete this project, but may not have asked above?

Many, many thanks for your professional contribution on this vital
matter.

Please try to return your response by April 15.

---


                 Police Medical Collaborations:  Phase I Protocol
Development
                           Summary and Overview [Italics]


The Police Executive Research Forum (PERF) is completing a Department of

Justice, Bureau of Justice Assistance (BJA) project to identify the
components of effective collaborations between police and emergency
medical personnel. (Here such personnel include physicians as well as
the
nurses, social workers/counselors, and EMS/EMT specialists who work with

them.)  Identification of effective collaborations will enable PERF to
draft information exchange protocols; protocols that will identify
populations who suffer intentional injuries, often misclassified as
accidental, resulting in emergency room admissions.  Often, these
injuries are powerful indicators of future violence, more serious injury

and death.  The objective of this project is to use police-medical
information exchanges to identify specific victim populations and their
injuries, in order to develop intervention protocols for working with
patients whose assaults represent indicators pointing to eventual
serious


trauma or death.  The role of police in this project will be to expand
their conception of crime control and even crime prevention to a broader

public safety orientation focusing on prevention and collaboration with
other disciplines that can prevent initial or further victimization.
This conception will include implementing the protocols to work with
medical personnel to identify at-risk citizens.  Police would then
engage
in creative problem-solving to shape interventions that continue to keep

those citizens out of harm's way, and focus on those who inflict the
injuries where the medical collaborators are legally permitted to do so
and feel comfortable assisting police in this regard.

In earlier projects that addressed homicide, domestic violence, and
victims' issues, PERF noted an important trend:  programs facilitating
the regular exchanges of information between police and medical
personnel
produced demonstrable and often empirically verifiable results.
Moreover, the collaborations that produced information sharing about
vulnerable populations are professionally enriching to a growing number
of medical specialists and their police partners.  Police are enriched
by
helping citizens determined to be at-risk by helping them avoid
life-threatening situations.  In this way, police acquire control over
the outcome of their official actions and unofficial mediations; a goal
that has eluded police who watch many arrestees plead to lesser offenses

or see presumably guilty defendants acquitted-often after committing
serious assaults and even homicide.  This medically driven,
evidence-based control over the outcome of interventions is the hallmark

of most true professions...but it has someone arrived at the doorstep of

law enforcement rather late.

Through alliances with medical experts, police acquire an additional way

to impact populations that are not currently reached by formal reliance
on the criminal law.  Physicians and ancillary experts have related to
us
how excited they are about the prospect of collaborating with law
enforcement because it expands textbook notions of quality of life to
address residential and other environments that in practice can be
difficult to impact.


As crime prevention has shifted to the center of the wellness and
quality
of life dimensions of community policing, police and medical leaders
could benefit from viewing these local partnerships as national models
for violence prevention.  PERF has considerable, proven experience with
this task through history of technical assistance and demonstration
projects that explain the steps involved in developing successful
collaborations-how they were structured and exactly what types of
information, mutually beneficial to each profession, could be legally
shared.

In spite of growing bodies of both anecdotal and scientific evidence of
the impact of the collaborations, these innovations appear to be
virtually unknown outside of a few pioneering cities and hospitals that
have nurtured them.  For many reasons, the benefits of police-medical
collaborations have not received the national attention that is
necessary
for even moderate diffusion throughout the medical and police
professions.  To be candid, this is very puzzling to us and, with your
help and that of others, certainly need not persist.

Police-medical collaborations are both practical in design and
cost-effective in execution.  This is a basic reason for PERF's
involvement and explains our interest in expanding the collaborative
approach to many more jurisdictions-beyond the ten or so that we have
found so far.  PERF believes the law enforcement and medical professions

have a shared but historically separate interest in identifying the root

causes of injuries; especially life threatening injuries resulting from
a
criminal act, and that it is our responsibility to aid in the process of

diffusion of an innovation of this significance.

PERF is completing the first phase of this nationwide effort to
encourage
police executives to embrace the literal meaning of wellness in their
communities by teaming with local medical professionals.  In the near
future, PERF staff expects to be able to point to both proven and
promising collaborations leading to measurable homicide-reduction on a
grand scale.  If this works, local police-medical alliances will
dramatically improve community quality of life by saving what appears to

be a predictable numbers of lives-the lives of infants who suffer from
shaken baby syndrome, spouses suffering from domestic violence, and the
elderly who experience devastating emotional and physical abuse.

PERF's role will be to serve as convener and moderator or a national
summit meeting to draft protocols specific to at-risk populations and
the
kinds of injuries to which they are most vulnerable.  Later, PERF will
take this information and prepare it in a prescriptive manner, and serve

as the exhorter of our members and then chronicler of yet additional
successful programs.  To complete this set of tasks in a timely manner,
we request your assistance in providing basic information about the
injuries with which you are most familiar and the characteristics of
victims who are most vulnerable.  We are also interested in you ideas on

what preventive interventions have worked, or would work if police
routinely collaborated with medical personnel.