Dedicated delayed intimate partner violence (IPV) screening improves IPV survivor identification

Intimate partner violence (IPV) is a global health crisis with long-term physical and mental health consequences. Patients impacted by IPV who present to the hospital, for related or unrelated causes, are at risk for future IPV-related hospitalisations. Thus, universal screening has been recommended to ensure IPV identification to better deliver necessary resources. Unfortunately, there are many barriers to consistent patient-centred IPV screening. We hypothesised that dedicated delayed screening (DDS) for IPV identifies more patients at risk for IPV than early screening (ES).

This is a retrospective study at a level-1 trauma centre of trauma patients (ages 15 and older) admitted July 2022-October 2023. Standard practice was ES, an IPV assessment administered on hospital arrival as part of a broader determinants of healthcare screen. DDS is a dedicated screen, implemented in July 2022, administered during tertiary survey after initial workup/disposition. Fisher's exact test and Mann-Whitney U test were used for data analysis.

4527 patients were included. Although fewer patients were screened by DDS than ES (202 (31.2%) vs 1414 (4.5%), p<0.001), DDS detected IPV more frequently than ES (13 (6.3%) vs 8 (0.6%), p<0.001). Patients screened by DDS were younger and had a longer length of stay than ES (p<0.05). In total, 21 patients screened positive, none by both DDS and ES. DDS resulted in >200% increased IPV identification.

DDS screening identified more victims when compared with ES. Improved DDS and ES compliance is needed to safeguard IPV detection. Based on this study, we suggest a two-phase screening approach, ES followed by DDS, to better ensure IPV identification.