Developing a multidisciplinary approach within the ED towards domestic violence presentations

Area of Science:

• Emergency Medicine
• Public Health
• Quality Improvement

Background:

• Domestic abuse (DA) presents a significant challenge in emergency departments (EDs).
• Effective detection and management of DA are crucial for patient safety and well-being.
• Existing ED protocols may not adequately address the complexities of identifying and supporting individuals experiencing DA.

Purpose of the Study:

• To enhance the identification and quality of care for patients presenting with suspected or confirmed domestic abuse in an emergency department setting.
• To implement and evaluate a specialized service and structured training program for ED staff.

Main Methods:

• A quality improvement initiative was undertaken in an emergency department.
• Key strategies included introducing an Independent Domestic Violence Advocate service, delivering structured staff training, and developing a standardized risk assessment and case management form.
• The process was reviewed quarterly.

Main Results:

• Over a 12-month period, 172 referrals were made, serving 121 distinct clients.
• Emergency department staff reported increased confidence in detecting domestic abuse.
• Community partners recognized the service's positive impact on DA detection and care quality.

Conclusions:

• Strong leadership and departmental prioritization were key to the successful development and implementation of the DA service.
• Collaboration with community partners was essential in tailoring the service and training to meet the needs of both staff and patients.
• The integrated approach significantly improved the management of domestic abuse presentations within the ED.