Review article: Emergency department data sharing to reduce alcohol‐related violence: A systematic review of the feasibility and effectiveness of community‐level interventions

Abstract

The present paper aims to review current evidence for the effectiveness and/or feasibility of using inter-agency data sharing of ED recorded assault information to direct interventions reducing alcohol-related or nightlife assaults, injury or violence. Potential data-sharing partners involve police, local council, liquor licensing regulators and venue management. A systematic review of the peer-reviewed literature was conducted. The initial search discovered 19,506 articles. After removal of duplicates and articles not meeting review criteria, n = 8 articles were included in quantitative and narrative synthesis. Seven of eight studies were conducted in UK EDs, with the remaining study presenting Australian data. All studies included in the review deemed data sharing a worthwhile pursuit. All studies attempting to measure intervention effectiveness reported substantial reductions of assaults and ED attendances post-intervention, with one reporting no change. Negative logistic feasibility concerns were minimal, with general consensus among authors being that data-sharing protocols and partnerships could be easily implemented into modern ED triage systems, with minimal cost, staff workload burden, impact to patient safety, service and anonymity, or risk of harm displacement to other licensed venues, or increase to length of patient stay. However, one study reported a potential harm displacement effect to streets surrounding intervention venues. In future, data-sharing systems should triangulate ED, police and ambulance data sources, and assess intervention effectiveness using randomised controlled trials that account for variations in venue capacity, fluctuations in ED attendance and population levels, seasonal variations in assault and injury, and control for concurrent interventions.

Last drinks: A study of rural emergency department data collection to identify and target community alcohol‐related violence

“…In the UK, several similar studies (albeit in larger cities with larger hospitals and longer data collection periods than the current trial) found that sharing ED recorded data with intervention partners resulted in significant reductions in violent crime, hospital admissions related to violence and assault, and alcohol‐related assault attendances . Potential interventions trialled elsewhere include restricted trading hours at high‐risk venues, stricter policing of responsible alcohol service at problem venues, targeted policing and CCTV placement in violence hotspots in streets, increased late‐night public transport to get people away from the Central Business District violence hotspots, traffic management options like pedestrian‐only streets, and public health campaigns to reduce alcohol harm in the home (packaged liquor and pre‐drinking) . Future research should attempt to trial such interventions and measure efficacy in an Australian nightlife and policy context.…”

“…It is frequently referred to as the ‘Cardiff’ (UK) model, as advocates of ED data sharing emphasise the potential for improved harm‐reduction interventions through the identification of problematic venues, liquor outlets and high‐risk neighbourhoods, and by targeting the most effective application of limited first response resources, such as police and ambulance . A recent systematic review of seven UK trials and one Australian pilot concluded that data sharing with community partners is feasible with minimal cost or burden on resources, and was consistently associated with substantial reductions to assaults and ED attendances post‐intervention . All studies included in the review deemed data sharing a worthwhile pursuit.…”

“…All studies included in the review deemed data sharing a worthwhile pursuit. All studies that attempted to measure intervention effectiveness reported substantial reductions of assaults and ED attendances post‐intervention, with one reporting no change …”

Security interventions for workplace violence in the emergency department

“…The proportion of 50% being perpetrated by repeat offenders may be higher if data from surrounding EDs could be incorporated into a central database of WPV. If such data sharing could be established among health services, pre‐emptive de‐escalation strategies against WPV and other violent behaviours may be initiated on patient arrival and potentially significantly lower the incidence of WPV …”

Effects of brief intervention on subgroups of injured patients who drink at risk levels

“…A unique addition to our current model compared with our previous models is the inclusion of the ‘trouble with law’ indicator. This addition was based on the demonstrated relationships in the literature between drinking, injury and legal involvement 25 26…”