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Individualized performance feedback to increase prenatal domestic violence screening
Mary M Duncan1, Patricia A McIntosh, Catherine D Stayton
1Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA. mmduncan@mail.computer.net
Maternal and Child Health Journal
|May 20, 2006
Summary
Individualized performance feedback with peer comparison (IPF) significantly improved domestic violence (DV) screening rates among obstetrics and gynecology residents. This enhanced protocol adherence increases patient safety and care opportunities.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Medical Education
Background:
- Universal domestic violence (DV) screening during pregnancy is recommended but infrequently implemented.
- Clinical leaders aimed to enhance adherence to DV screening protocols in prenatal care settings.
Purpose of the Study:
- To assess the impact of individualized performance feedback with peer comparison (IPF) on DV screening rates among obstetrics and gynecology (ob/gyn) residents.
- To improve compliance with a universal DV screening protocol in a prenatal clinic.
Main Methods:
- A prospective study was conducted in a northeastern urban hospital-based prenatal clinic serving low-income women.
- Residents received DV training, followed by four IPF reports at seven-week intervals.
- Medical records were audited to compare DV screening rates before and after IPF implementation.
Main Results:
- DV screening rates increased from 60% before IPF to 91% after the fourth IPF report (p<.001).
- The odds of screening after the final IPF report were 7.6 times greater than before IPF (95% CI: 3.0, 19.0).
Conclusions:
- IPF was significantly associated with improved DV screening among ob/gyn residents.
- Enhanced screening promotes protocol compliance and increases opportunities for patient disclosure, education, and treatment.
