Feasibility of computerized screening for intimate partner violence in a pediatric emergency department

This study aimed to evaluate the feasibility of caregiver-initiated computerized screening in a pediatric emergency department (ED) to identify home safety risks, with a specific emphasis on intimate partner violence (IPV).

Home safety screening kiosks were developed using information technology as the first step in a plan to decrease family violence. Caregivers self-initiated a standard-of-care screening process that included both non-IPV and IPV items. An ED social worker received an automated text page and printed summary of the findings when a caregiver endorsed IPV. System activity was tracked by comparing frequency of completed screens to the daily ED census and by determining the percentage of completed screens that were positive for IPV. The reliability of the technology was evaluated as percentage of days of system downtime. Meetings with ED personnel and direct observations of families were conducted to identify potential barriers and successes to the technology utilization.

During a 15-month period, 13,057 computerized screens occurred, with a 4-fold increase in the computerized screening rate after ED triage nurses became champions of these efforts. Fourteen percent of the computerized screens were positive for IPV. The reliability of the technology was considered quite high, with rare system downtime (4.2% of days) reported during the 15 months. There were several themes identified by caregivers and providers regarding barriers to successful use of the safety screening.

A reliable, caregiver-initiated system is possible to offer consistent opportunity to conduct unobtrusive, private screening for IPV and other home safety concerns.