More Than Survival: Healing Trauma From Violence

Summary

Advancing Health Podcast
Episode: More Than Survival: Healing Trauma From Violence
Date: May 11, 2026
Host: Jordan Steiger, American Hospital Association
Guests: Dr. Eleanor Kaufman, Medical Director, Penn Trauma Recovery Program; Michelle Volpe, Chief Operating Officer, University of Pennsylvania Health System

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Overview

This episode explores Penn Medicine's Trauma Violence Recovery Program—a hospital-based violence intervention program (HBVIP) at Penn Presbyterian Medical Center in Philadelphia. The conversation highlights the comprehensive support HBVIPs provide to survivors of violence, addressing both physical and psychosocial healing, and discusses the importance of integrating such programs within health systems. The conversation features key insights from program leaders, data on patient outcomes, and practical advice for other organizations interested in starting similar initiatives.

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Key Discussion Points & Insights

What is a Hospital-Based Violence Intervention Program? (HBVIP)

• Definition: HBVIPs offer dedicated, individualized psychosocial support and long-term case management to survivors of interpersonal and community violence, bridging the gap between the hospital and community-based recovery.

  • Dr. Kaufman (01:24): “Hospital based violence intervention programs...provide dedicated support to survivors of violence...case management and navigation of hospital, health system, community, municipal resources to try to get patients all of the things…they need to make as full of recovery as possible.”

• Unique Approach: Use of "credible messengers"—staff with shared backgrounds or experiences who build trust and rapport with patients.

• Addressing Broader Needs: Beyond physical injuries, HBVIPs assist with mental health, housing, relocation for safety, job training, education, and replacing crucial documents.

Process and Patient Experience

• Immediate Engagement: Violence recovery specialists meet with patients as soon as possible after stabilization post-injury.

  • Dr. Kaufman (02:52): “They generally start by just trying to connect with them, build rapport, let the patient know what the program is, what resources are available…every patient receives an individualized intervention.”

• Sustained Support: Specialists maintain frequent contact—often several times a week for months—helping with everything from therapy access to relocation and employment.

Why Should Health Systems Be Involved?

• Community Impact:

  • Michelle Volpe (05:11): “Violence touches everyone...the health system is also a part of the community…This program is one that helps trauma victims heal…emotionally return to their community and contribute...in a way much more significant than they had previously.”

• Staff Well-being: Provides emotional support to staff, who are impacted by each trauma case.

• Reducing Recurrent Injury:

  • Dr. Kaufman (07:16): “There’s very few things that’s worse as a clinician...than to take excellent care of a patient and then see them come back...Programs like this have been shown to reduce recurrent violent injury dramatically...in some studies, where a quarter of people were coming back, now it’s down to 5%...10% down to zero percent.”

• Systemic and Economic Benefits: Reduced recidivism saves health system resources, allowing funds to be directed elsewhere.

The Investment Case for HBVIPs

• Human and Financial Return:

  • Michelle Volpe (10:06): “When you invest in people, it is a benefit that gives back time and time and time again...it’s also a benefit in terms of health care costs.”

• Building Organizational Culture: Staff feel pride and buy-in seeing the health system invest in holistic patient care.

• Transformative Stories:

  • Michelle Volpe (11:29): “There’s not a dry eye in the room...seeing that they were able to recover...holding down meaningful jobs, the value of that is almost priceless.”
  • Dr. Kaufman (12:15): “This program was the thing that got me to go out of the house because I was having such severe hyper vigilance and PTSD symptoms...This program kept me from going back to selling drugs...It encouraged my friends and family not to get involved in retaliatory violence.”

Advice for Others: Starting a Program

• National Support Networks: The Healthcare Alliance for Violence Intervention (HAVI) provides training and structure for new HBVIPs.

  • Dr. Kaufman (13:59): “The National Organization...is called the HAVI, the Healthcare Alliance for Violence Intervention...that’s a great resource if you’re thinking [of] starting a program.”

• Engage Community and Staff: Listening to staff and community members quickly clarifies the need and motivates support.

• Essential Part of Trauma Care:

  • Michelle Volpe (14:54): “If you have a trauma program...you must do this...It is just so important to heal both the physical and the emotional...This investment is necessary to have a full trauma program.”

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Notable Quotes & Memorable Moments

• "Violence touches everyone. It affects everyone—the victim, obviously, their family, friends, the community, but also staff."
  — Michelle Volpe, 05:11

• "Programs like this have been shown to reduce recurrent violent injury dramatically...where a quarter of people were coming back, now it's down to 5%."
  — Dr. Eleanor Kaufman, 07:16

• "When you invest in people, it is a benefit that gives back time and time and time again."
  — Michelle Volpe, 10:06

• "The stories that I get to hear…this program kept me from going back to selling drugs...encouraged my friends and family not to get involved in retaliatory violence."
  — Dr. Eleanor Kaufman, 12:15

• "Particularly if you have a trauma program…you almost cannot not do this, you must do this...to heal both the physical and the emotional."
  — Michelle Volpe, 14:54

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Important Timestamps & Segments

• 00:22 – Introduction of guests and episode topic
• 01:24 – What is an HBVIP? Overview and goals
• 02:52 – The patient journey and program interventions
• 05:11 – Why violence recovery is a health system issue
• 07:16 – Program impact on staff, recurrent injury, and health economics
• 10:06 – Investment rationale and staff perspectives
• 12:15 – Patient stories: breakthroughs and lasting recovery
• 13:59 – Starting a program: resources and advice
• 14:54 – The necessity of addressing emotional trauma in trauma care

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Resources Mentioned

• Healthcare Alliance for Violence Intervention (HAVI): www.thehavi.org – Offers training and support for HBVIPs.

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Conclusion

This episode makes a compelling case for hospital-based violence intervention programs as both a moral imperative and a practical tool for community healing. By combining leadership commitment, sustained patient support, and evidence-based practice, programs like the one at Penn Medicine are changing trajectories for survivors, staff, and whole neighborhoods. For organizations interested in starting their own initiatives, engagement with HAVI and community partnerships is the recommended first step.

Transcript

[Podcast Host]

Welcome to advancing health. Roughly 50% of victims of violence develop depression or PTSD afterwards. Today we hear how Penn Medicine's Violence Recovery Program offers psychosocial support and individualized interventions that accelerate the path to healing.

[Jordan Steiger]

My name is Jordan Steiger and I am the Director of Behavioral Health and Violence Prevention at the American Hospital Association. I'm really excited for this episode. I am joined by Dr. Eleanor Kaufman, who is the medical director of the Penn Trauma Recovery Program, and by Michelle Volpe, who is the Chief operating officer of the University of Pennsylvania Health System. And we're going to discuss today the Penn Trauma Violence Recovery Program, which is a hospital based violence intervention program based at the Level 1 Trauma center at Penn Presbyterian Medical center in Philadelphia. We're going to learn more today about what an HBVIP actually is for those that don't know and discuss how senior leaders can support to these programs. So Dr. Kaufman and Michelle, thank you so much for being here today.

[Michelle Volpe]

You're welcome.

[Dr. Eleanor Kaufman]

Thank you so much.

[Jordan Steiger]

So before we dive into the details of your program and talking about Some more information, Dr. Kaufman, can you just explain to our listeners what a hospital based violence intervention program is and tell us a little bit more about your program?

[Dr. Eleanor Kaufman]

Yeah, absolutely. Patients who are injured through interpersonal violence, community violence often really struggle with their recovery after injury. They face a lot. They have physical injuries, of course, which is what I'm trained to focus on as a trauma surgeon. But they also have to grapple with the mental health consequences of being hurt in that way. So we know that about 50% of people go on to develop depression and or PTSD. Community violence is also very tied to social factors, poverty and discrimination, lack of access. So our patients come in with a lot of adversity and then the experience of injury can make it worse. Hospital based violence intervention programs have been around for about 25 years. Ours is relatively new, but these programs exist to provide dedicated support to survivors of violence. We work with credible messengers who have a shared background and set of experiences can really connect to our patients. They provide psychosocial support, they and an enormous amount of case management and navigation of hospital, health system, community, municipal resources to try to get patients all of the things, all of the components that they need to make as full of recovery as possible.

[Jordan Steiger]

So walk me through what that looks like. So say you have a patient that's coming in that you're treating as the trauma surgeon. Tell me what happens after the surgery.

[Dr. Eleanor Kaufman]

Yeah, so in our program, our frontline workers are called violence recovery specialists and they try to meet with any patient who is affected by violence as soon as possible after the patient is stabilized. They generally start by just trying to connect with them, build rapport, let the patient know what the program is, what resources are available to them, and every patient really receives an individualized intervention. So many patients, like I mentioned, have mental health care needs. And we have therapists who work with our program who are accessible to our patients. Many patients struggle with housing or need to relocate for their safety. So our violence recovery specialists are really experts at walking patients through, Working with relocation agencies through the Philadelphia city government, for example. Those are two of the most common needs that our patients have. But it ranges from getting people back to school, getting people job training, Replacing things that were lost, like patients, Driver's licenses and phones and identification. It really runs the gamut. So our violence recovery specialists start working with patients as soon as possible after injury. But what makes the program or programs like this really special is how long the relationship can last. So when I take care of a patient, they get through their hospitalization, they get through their surgery, they recover, they leave the hospital, they go home. Ideally, maybe I see them in the office once or twice to check on their healing. Our violence recovery specialists are working with patients. They're connecting with them twice a week, every week, sometimes every day, depending on the patient's need for months after injury, Oftentimes until patients are really back on their feet. So they really help bridge that gap between the acute hospitalization and the community and true recovery.

[Jordan Steiger]

That makes total sense. It sounds really like this HBVIP model is that bridge between community and hospital and trying to fill that gap between. So I'd love to hear, maybe. Michelle, we can start with you. Why is this an issue that health systems should care about? And why is this not just a community issue? Why should hospitals be involved?

[Michelle Volpe]

So violence touches everyone. It affects everyone. The victim, obviously, of the violence, Their family, friends, the community, but also staff. Every trauma patient that comes in to our trauma center is an emotional experience for our staff across the board. Physicians, nurses, and they take our staff takes every death personally as well as every success. Meaning a patient, a trauma patient, gets through an awful experience. They have a long way forward in terms of their recovery. They take that personally. I hear that all the time from members of our trauma team. The health system is also a part of the community, Particularly where Presbyterian is located in west Philadelphia. Although Presbyterian treats many, many patients from well outside of the west Philadelphia community, Many trauma patients are from our west Philadelphia neighborhoods and or surrounding neighborhoods. Trauma victims are Frequently known by community members. Not only are they frightened about what has happened in their community, but they are also very concerned about the recovery for a member of their community. This program is one that helps trauma victims heal. It helps them in a way where at some point they can. I don't mean just physically return to their community, but emotionally return to their community and contribute to their community once again, and many times in a way much more significant than they had previously.

[Jordan Steiger]

That makes a lot of sense. Eleanor, anything to add to that?

[Dr. Eleanor Kaufman]

When we started our program in 2021, it was new to Penn, and although it was an established model, we were really looking to see how it would go here. It's been wonderful with patients, but our program and our team has also been so welcomed by staff across the board. And, you know, our primary mode is that we pick patients up on the trauma service, of course, like I was saying, but we get referrals from social work, certainly, but also from physical therapy, from OB gyn, from family medicine. And I think it really speaks to how much staff and clinicians recognize the need, recognize their community members, like Michelle was saying, and how much they welcome having those additional resources to offer. I think it's a little bit of an antidote to some of the burnout that we experience when we're taking care of problems that, on some level, we really can't fix. So I think it helps us, and it helps the health system reach further into the community and go that extra mile. The other thing I would add that we haven't talked about is one of the reasons that programs like ours were started is because of the challenge of recurrent violent injury. So violence, like other medical problems like heart disease, like stroke, can become a recurrent disease. So patients had risk factors beforehand, and now they have more risk factors. And there's very few things that's worse as a clinician, as a trauma surgeon, than to take excellent care of a patient and then see them come back with the same or worse injuries. Of course, programs like this have been shown to reduce recurrent violent injury dramatically. In some studies, where a quarter of people were coming back, now it's down to 5%. Where 10% of people were coming back, in some studies, it's down to zero percent. I always get anxious when I quote our numbers because I worry about the next person and wanting to protect them. But we've seen similar effects here. That's good for patients, it's good for staff. And, you know, I will have to acknowledge that it's good for the economics of Healthcare as well. Hospitalization that we can prevent is money we can save and use for other necessary care. So it's really good for us all around.

[Jordan Steiger]

Thank you for sharing those statistics. I mean, hearing that, you know, that reoccurrent time back in the hospital can get down to 5% or 0% in different studies is really, really incredible. And you did touch on the financial piece, which I'm sure is something that people listening to this might be worrying and wondering about. You know, how would I start this at my organization? How much does this cost? And I think, Michelle, you can really give some insight as the COO of your health system. Tell me a little bit about why making this kind of investment matters to you and matters to your system.

[Michelle Volpe]

It matters because it is an investment in people. When you invest in people, it is a benefit that gives back time and time and time again. Employees. Those who have supported trauma patients, not just those who have supported trauma patients, but many across the system, they see the work that is being done in this program, and they recognize that PEN has stepped up and it has made a commitment in people. When you see that a commitment in people is being made now I'm speaking for myself, that makes me feel as though I'm with a health system that really cares. Also, Eleanor shared that this program has shown, I mean, statistically, to help reduce violence in the future. Those individuals who go through this program, they are many times over, individuals that will not again get involved in similar types of situations. And that's a benefit, obviously, to the community. It's a benefit to the hospital, but it's also a benefit in terms of health care costs.

[Jordan Steiger]

Right.

[Michelle Volpe]

I would also say that this commitment is one that staff takes very seriously. I've been in a number of sessions where Eleanor and her team members have spoken. And I'm telling you, there's not a dry eye in the room. Stories are brought forward, individuals who have had some very serious things happen to them. They've been able to recover physically, but then seeing that they were able to recover and. Or are recovering emotionally, holding down meaningful jobs, the value of that is almost priceless.

[Jordan Steiger]

I mean, absolutely. And Eleanor, do you have anything to add to that?

[Dr. Eleanor Kaufman]

I mean, I could talk about this all day. I'm a researcher as well, and I love the numbers. But one of the great privileges that I have in working with this program is all the stories that I get to hear. And so there's a lot of challenges that I hear about as well. But when I hear a patient say, you know, this program was the thing that got me to go out of the house because I was having such severe hyper vigilance and PTSD symptoms. This program kept me from going back to selling drugs when I thought that might have been my only option. This program encouraged me to, to encourage my friends and family not to go look for the person who hurt me, not to get involved in retaliatory violence. Working with my violence recovery specialist made me realize I want to get back in school. We hear these stories time and time again and like I said, we hear other more challenging stories too. But our patients give us these gifts over and over again of resilience and hope and encouragement. And to be able to support that from our side is, is really special. And I think like Michelle said, it's another way of caring about them and they feel that and they know that and they believe in it.

[Jordan Steiger]

Yeah, that investment in whole person care I think is just so palpable in hearing the way both of you are talking about this. And I mean just thinking about them in every aspect of their life, not just their healthcare, I think is something we can all aspire to that are listening today. So I think that's incredible, incredible work that you're doing. If somebody is listening to this and maybe feels inspired to look into this for their own organization, what would you tell them? What's your big piece of advice?

[Dr. Eleanor Kaufman]

Like I mentioned, programs like this have been around for about 25 years. Ours started in 2021. The National Organization that provides training and support and structure for programs like this is called the havi, the Healthcare alliance for Violence Intervention. So that's a great resource if you're thinking, want to learn more about hvips or you're thinking about starting a program. When I was thinking about starting this program, I was strongly and immediately encouraged by community members that I talked to, by staff members that I talked to. So I think if you, if you get out in your community, it will be easy for people to recognize the need and the opportunity. Like I said, I can talk about this all day and I think anybody who works with this program will. So I'm certainly happy to be a resource with whatever I know and I think anybody in a similar program wants to share.

[Michelle Volpe]

I would add that particularly if you have a trauma program that you almost cannot not do this, you must do this. It's so important and I've learned this from Eleanor and her team. It is just so important to heal both the physical and the emotional. And the emotional goes, you know, just beyond psychological. Right. This investment is necessary to be able to have a full trauma program and one that just doesn't fix the physical injuries, but goes well beyond that and provides a significant healing.

[Jordan Steiger]

Absolutely. And AHA is a member of the HAVI as well. I'll echo that. It's a great resource and we can definitely link to the havi's website in the description so people can access that information. If I could add my own lesson learned from listening to you, I think one thing I really want to point out to our listeners is that we have great combination of leaders here. We have our trauma surgeon who leads the program and we have our coo. And I think having both of you engaged and as passionate as you are about this work really has helped it move forward. You are doing incredible work and we are just so happy and proud that you are members of AHA and willing to share your story with us. So thank you both so much for being here.

[Dr. Eleanor Kaufman]

Thank you so much for having us. Us.

[Michelle Volpe]

Yes. Thank you.

[Podcast Host]

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