For pediatric trauma surgeon Chethan Sathya, gun violence prevention is deeply personal.
He’s operated on babies, children, and teens with gunshot wounds and seen firsthand the devastating toll firearm injuries take on families and communities.
Sathya has also spent years helping hospitals move from recognizing the problem to implementing solutions as founding director of Northwell Health’s Center for Gun Violence Prevention.
Now, a new toolkit makes that more practical than ever.
It offers hospitals a roadmap for creating firearm injury and violence prevention programs tailored to their communities.
The toolkit outlines nearly 100 proven clinical, community, and system-level strategies hospitals and health systems can adapt and scale over time.
“There is no one-size-fits-all approach to gun violence prevention,” said Sathya, MD, who is also the trauma director at Northwell’s Cohen Children’s Medical Center. “For years, health care providers around the country have been building and researching approaches to reduce firearm injuries and prevent gun violence. This resource brings those lessons and best practices together in one place.”
One of the toolkit’s strengths is its flexibility. Rather than prescribing a single approach, it recognizes hospitals have different needs, resources, and community contexts.
Screening for firearm injury risk may be the right starting point for one organization, while another may focus on research, hospital-based violence intervention, partnerships with community organizations and schools, mentorship programs, or public health awareness efforts.
“The beauty of the toolkit is it demonstrates that no matter where you are as a hospital, there’s something you can do,” Sathya said.
2 questions to prevent tragedy
The toolkit arrived alongside another tool from Northwell: its firearm safety screening protocol built into Epic. Hospitals and clinics using the EHR system now have a ready-to-use script to incorporate gun injury prevention into existing workflows, while establishing more consistent data collection to drive research and future approaches.
Clinicians know a simple conversation lasting just seconds could prevent a tragedy. That’s why they’ve been asking patients and families about topics like mental health and alcohol use at every visit for years.
But Sathya said one of the biggest barriers can be getting firearm-related screening questions into EHR systems.
“From a usability standpoint, you want to decrease friction and make things as easy as possible,” he said. “For already overburdened providers, streamlining that process through the EHR is critical.”
The protocol includes one question about firearm access at home and another about the patient’s exposure to community violence.
And it opens the door for clinicians to offer guidance, connect patients with resources, such as free gun locks available at many children’s hospitals, and identify those who may benefit from additional support through hospital-based violence intervention programs.
A culture shift
For Sathya, the significance extends beyond the technology. When clinicians open an EHR and see firearm access included alongside other routine health screenings, it signals that the topic belongs in everyday clinical practice.
“Think about the shift,” he said. “As a health care worker, you’re seeing that this is something I need to be asking about. That shift in culture matters.”
While research supports clinician counseling on firearm safety and violence prevention, relatively few providers routinely discuss these risks with patients and families.
Sathya said making screenings universal and the standardized questions readily available will be especially valuable in rural areas, where firearm ownership and gun suicide and gun homicide rates are higher, and prevention resources may be harder to access.
Since launching the NIH-funded “We Ask Everyone” research study in 2020, Northwell has screened more than 300,000 patients across its health system and delivered thousands of interventions based on their answers to those two questions.
Beyond the script
Sathya emphasizes that screening is not the end goal.
Hospitals must determine how they will respond when risks are identified, whether through counseling, referrals, violence intervention services, community partnerships, or other evidence-based strategies.
The toolkit provides guidance on hospital leadership engagement, implementation planning, funding opportunities, overcoming barriers, and building sustainable programs from hospitals and health systems that have already tested, refined, and scaled these approaches.
“It’s really that follow-through,” Sathya said. “The first step is getting the questions in place. The next step is hospitals having the will and the champions to activate a program.”
