Introducing the Stepping Strong Injury Prevention Program
Ali Salim, MD, is the medical co-director of The Gillian Reny Stepping Strong Center for Trauma Innovation and the chief of the Division of Trauma, Burn, Surgical Critical Care and Emergency General Surgery at the Brigham. In this interview, Salim outlines his vision for reducing the number and severity of traumatic injuries in Boston and beyond.
Q: Congratulations on your appointment last summer as co-medical director of the Stepping Strong Center. Tell us a little a bit about your background, and why you chose to focus on the care of acutely ill trauma patients.
A: Thank you. It is truly a privilege and honor to be a part of the Stepping Strong Center. In terms of my background: I grew up in New York, went to high school in Pennsylvania, college at Duke University, Medical School at Howard University, and my surgical training and trauma fellowship in Los Angeles. During my freshman year at Duke University, to get to class, I had to walk by the University Hospital to get to the main campus every day. I really hadn’t been exposed to medicine before this, and I became very curious, so I decided to volunteer in the emergency room.
Spending time in the emergency room, I watched and learned—and that experience ultimately led me to focus my career on the care and outcomes of trauma patients. During my surgical training, I gravitated towards trauma because it is the one specialty that can immediately help patients who find themselves in the hospital after a totally unexpected and sudden traumatic event.
Q: Under your leadership, the Stepping Strong Center is launching a new Injury Prevention and Intervention program. What is your vision for the program and how does it intersect with the center’s current initiatives?
A: When you look at the main purpose of the Stepping Strong Center, it is centered around gathering multidisciplinary experts to improve outcomes of trauma patients through research, advocacy, education, and community engagement. The Injury Prevention Center was created to fulfill four goals: (1) to prevent injury; (2) to improve care and outcomes after injury; (3) to promote community interventions and engagement; and (4) to study and implement best practices with respect to injury prevention.
Not only are we trying to improve outcomes for patients with traumatic injuries; we are also trying prevent the injuries before they happen. These goals work synergistically with Stepping Strong’s core mission.
"Not only are we trying to improve outcomes for patients with traumatic injuries; we are also trying prevent the injuries before they happen. These goals work synergistically with Stepping Strong’s core mission." —Ali Salim, MD
Q: What kinds of injuries are you working to prevent?
A: We are working to prevent all types of injuries we commonly see here in Boston. Falls are the most common mechanism of injury so we will definitely focus on that. But we will also focus on things like distracted driving, interpersonal violence, and gun control to name a few. Our hope is to put programs in place that educate the public, identify best practices, and finally, disseminate our findings so other organizations can benefit from what we’ve learned.
Q: How do you go about educating the community about best practices in injury prevention?
A: We start with patients who have already had an injury and come to the hospital. Part of our management is to identify their specific risk factors for injury. For instance, say an elderly patient is admitted because he or she falls. We might discuss specifics like, what would make their living space safer? Would it help if they kept the lights on to see better at night? Would it be safer to move their bedroom to the first floor? Would it make sense to change the shoes they wear? We would also look at possible medical reasons for why they fell in the first place. For instance, maybe they were dizzy and fell because of the blood pressure medications they took. Just adjusting their medications would be a simple way to prevent further falls.
Q: Can you talk about services for patients confronted with domestic violence?
A: We have a program for people who are involved in interpersonal violence. We work with them to ensure they will return to a safe environment, that they have access to social services, and, if needed, they have assistance in things like looking for a job. There are a lot of useful resources in Boston; the Stepping Strong injury prevention program will be one avenue to educate and empower our patients so they can take advantage of those resources.