Updates in firearms access screening

As the United States started to emerge from COVID-19 restrictions in early 2021, we witnessed a spate of mass shootings in cities across the country. While these searing images – 8 people dead at an Atlanta spa, hundreds terrorized while grocery shopping in Boulder, Colorado – so often frame the narrative of gun violence in America, suicide by firearm accounts for more than 60% of all deaths from gun violence across the United States and remains an under-recognized threat. Additionally, living in a home with a firearm increases an adolescent's risk of death. In our study “Screening for Access to Firearms by Pediatric Trainees in High-Risk Patients,” we reviewed screening for access to firearms by pediatric residents in patients with suicidal or homicidal ideation who presented to a pediatric emergency department. We found that this screening was documented in only 5% of these encounters. Furthermore, 5% of patients were discharged home without this potentially life-saving screening having been completed by any provider. Because this low screening rate represented a critical missed opportunity to address a potentially modifiable risk factor, our team subsequently completed a quality improvement project after which the rate of screening increased to 34%. While this was a positive change, it still left the majority of our patients unscreened and significant room for improvement.