Hawaii Injury Prevention Plan (HIPP)

Core Capacity to Sustain Injury Prevention

Background

Since the release of the 2005-2010 and 2012-2017 Hawaii Injury Prevention Plans (HIPP), the Hawaii State Department of Health, Emergency Medical Services & Injury Prevention System Branch (EMSIPSB) has continued to work closely with partners in the community to build and strengthen the infrastructure to support injury prevention policy, research, surveillance and programs in Hawaii.

While EMSIPSB and IPAC have made tremendous strides, the priorities for injury prevention in Hawaii evolved. Based on the views and values captured from the Spring 2018 IPAC membership survey, accomplishments in injury prevention, and core capacity recommendations are refreshed in this section. The EMSIPSB and IPAC welcome all partners ready to engage in these critical public health recommendations to improve the lives of individuals and the overall health and well-being of our community. With the exception of Recommendation 3 which has been revised for improved clarity, the HIPP Core Capacity Recommendations remain constant and new priorities have been established for each of the six Core Capacities, extending the Plan through 2023.

Accomplishments 2009-2019

Program and policy accomplishments from every area of injury prevention is highlighted in the timeline below. Notable successes include 1) the all passenger seat belt bill was passed by Act 73 in 2013, 2) the 2015 Good Samaritan Law was passed to provide drug overdose immunity and set the stage for future drug overdose prevention efforts, 3) the 2017 Legislative endorsed the Suicide Prevention Strategic Plan to reduce suicides by 25% by 2025 through HCR66, and 4) first statewide Drowning and Aquatic Injury Prevention Advisory Committee established in 2017.

Recommendations

The EMSIPSB and the Steering Committee of the IPAC are continuing to build on the far reaching efforts of the HIPP, first initiated in 2005, revised in 2012, and now updated in 2018. With the exception of Recommendation 3 which has been revised for improved clarity, the HIPP Core Capacity Recommendations remain constant and new priorities have been established for each of the six Core Capacities, extending the Plan through 2023. Detailed Core Capacity Recommendations can be found below.

Recommendation 1: Build and sustain infrastructure to provide leadership, data, technical assistance, and to support policy and evaluation for advancing injury prevention.

In the years since 2012 when the current HIPP was established, the role of injury prevention as a leading force for collaboration in support of public health initiatives has grown, particularly in response to emerging health issues such as trauma, technology impact on drowning prevention and impaired driving, opioid and substance abuse prevention, fall prevention as part of healthy aging, and the cross-cutting areas related to traumatic brain injury prevention.

This recommendation is central to the success of all the other Core Capacity Recommendations because its focus is on assuring sufficient infrastructure and resources exist to fulfill the mission of injury prevention.  The expanding leadership role of injury prevention requires continued focus on sustaining and growing the infrastructure underpinning IPSC’s ability to respond efficiently and effectively statewide to an increasingly engaged community.  

Areas requiring particular attention include: maintaining and growing the data capacity to respond to the growing demand for data to support evidence-based decision making and well-informed policy initiatives; securing and coordinating the training and technical assistance in injury prevention among the IPAC membership and broader community; and continued leadership development and support to sustain and expand collaborative engagement among all concerned constituents.

Recommended Next Steps

• Reorganize the Injury Prevention System Branch to better fulfill its mission in alignment with injury needs, including the addition of key positions where the needs are not adequately met.
• Engage in leadership development for IPAC and other injury prevention coalitions through collaboration and mentoring. 
• Regularly update the cost/benefit analysis of the burden of injury.
• Secure sufficient staffing to meet the epidemiological and statistical needs of EMSPSB.

Recommendation 2: Serve as a clearinghouse for data, and incorporate other injury data sources to strengthen analyses and further injury prevention efforts.

Timely, high quality data is vital in targeting limited resources – monetary, policy, collaboration, staff, community engagement – for the greatest value and impact.  EMSIPSB has developed a reputation for providing robust data and the demand is beginning to outstrip the capacity to respond. In addition, IPAC sees opportunities to expand the reach of this quality information through enhanced distribution through consumer-friendly communications.

Recommended Next Steps

• Maintain and expand EMSIPSB access to data.
• Promote the value and use of performance indicators to measure outcomes.
• Establish and maintain consumer-friendly communications on injury prevention.
• Establish and maintain online HIPP and a system for regularly updating data and other reports

Recommendation 3: Provide training and technical assistance to increase injury prevention knowledge and skills among health care professionals and professional education partners.

A robust training and technical assistance program that reflects the diverse areas of injury prevention must rely on the collaborative efforts of EMSIPSB, IPAC and other community organizations to identify, share and deliver quality services.  EMSIPSB and IPAC will lead the identification, coordination, and promotion of injury prevention-related core competency-based training opportunities in collaboration with the Hawaii Public Health Institute, and continue delivering technical assistance on an as needed basis.

Recommended Next Steps

• Assess the training and technical assistance needs in injury prevention among partners, practitioners and organizations working in related fields, and interested community members.
• Based on the results of the needs assessment, allocate resources towards relevant injury prevention and public health core competency-based training for existing and new workforce members. 
• Offer Injury Prevention 101 training and refreshers at least annually that include the latest advancements in the field for health care practitioners.
• Develop injury prevention training through the University of Hawaii system that meets the Interprofessional Education (IPE) requirement of the University of Hawaii at Manoa Schools of Nursing, Medicine, Social Work, and Pharmacy, and the Office of Public Health Studies

Recommendation 4: Cultivate awareness among decision makers and the public to elevate injury and violence as a major public health problem in Hawaii.

While injury prevention has seen significant strides in policy and program initiatives in recent years, there is still a lack of public knowledge about injury and violence and the impact of preventing injuries on overall health and well-being.  It remains imperative to effectively communicate the personal and financial costs of injury, as well as the potential solutions, in order to change behavior and ultimately prevent needless death and disability. EMSIPSB and IPAC are focused on developing accessible messages about injury prevention and evaluating the impact of increased awareness on safety practices.

Recommended Next Steps

• Develop, test and disseminate Hawaii-specific, consumer-friendly, targeted injury prevention messages covering all major injury areas.
• Inform partners about effective communication of injury prevention messages.
• Develop and disseminate data-informed policy papers for decision makers focused on legislative opportunities to advance injury prevention initiatives.

Recommendation 5: Inform injury prevention policy at all levels.

Establishing sound policy requires both good information and engaged champions who are prepared to show up and articulate the case effectively and passionately.  EMSIPSB and IPAC are focused on ensuring the case for injury prevention is brought to the forefront by partners who are well-informed, supported in coordinating their efforts, and successful in building strong policies.

Recommended Next Steps

• Pursue a proactive legislative agenda in support of IPAC’s annual priorities for action.
• Identify and support champions at the county, state and federal levels to advance injury prevention policy initiatives.
• Generate regular status updates on injury-related bills, e.g. through IPAC meetings and communications, and on the HIPP website.

Recommendation 6: Increase opportunities for collaborative injury prevention efforts in all injury prevention areas.

Injury prevention is at its core a collaborative endeavor across diverse areas of public health, government, nonprofit sector, and interested community members.  An ongoing priority for EMSIPSB and IPAC is reaching out to individuals and organizations to identify and cultivate new and emerging leaders, educating them on the leading areas of injury prevention, and inviting them to engage in collaborative efforts to affect change in the burden of injury and enhance the health and wellness of the people of Hawaii.

Recommended Next Step

• Build a broader base of support for advancing and sustaining injury prevention efforts by identifying and engaging injury prevention partners who are currently missing from IPAC and related coalitions staffed by EMSIPSB.
• Convene multi-sector groups for the purpose of increasing collaborative efforts across injury areas.