Details Matter: A Quality Improvement Study on Screening for Intimate Partner Violence at a Labor and Delivery Hospital
Background: It is estimated that one in three women will experience intimate partner violence (IPV) in their life time. It is recommended that healthcare professional screen patients for IPV, but screening rates and positive disclosure rates remain low. Best practices for screening for IPV in the healthcare setting include screening alone, showing compassion and non-judgement, asking specific and direct questions, and using a framing statement before the screening occurs.
Methods: A review of the screening protocol for IPV at a labor and delivery hospital revealed high screening rates (88%), low positive disclosure rates (0.43%), and that some best practices were not being followed. We utilized an iterative quality improvement process to update the IPV screening protocol to be more closely aligned with best practices. Changes included updating the security check-in process at the hospital to ensure that nurses had time alone with patients. After implementation of the new protocol, positive disclosure rates increased from 0.43% to 2.5%.
Discussion: By focusing on how IPV screening was being conducted, we were able to achieve a modest increase in positive disclosure rates at a labor and delivery hospital. Involving the nursing staff and leadership in development of the new protocol and communication were key components in the adoption of the new protocol.
Conclusion: Healthcare practices that screen for IPV and other social determinants of health should ensure that screening is conducted in a manner that aligns with best practices and is conducive to patients being comfortable with disclosing IPV and other social needs.
Key Take Away Points
- When implementing new programs and protocols, key components include: engaging with organizational leadership and staff; communication; and flexibility.
- Organizations that are screening for intimate partner violence should ensure that best practices are being incorporated into the screening protocol such as screening alone, showing compassion, and asking specific questions.
- By ensuring that best practices are being followed, labor and delivery hospitals can increase the percent of women that are disclosing intimate partner violence.
Nancy Correa is the Practice Administrator for the Section of Public Health Pediatrics at Texas Children’s Hospital. In this role, she leads community collaboratives to strategically address gaps in practice and knowledge to mitigate childhood adversities and foster resilience in individuals, families, and communities. Nancy has over fifteen years of experience in public health conducting needs assessments, implementing evidence-based programs, leading evaluations, and facilitating collaboratives. Nancy has a bachelors degree from Rice University in Chemistry and Policy Studies, a masters degree from Boston University School of Public Health, and a certificate in nonprofit management from Northeastern University.
Correa, Nancy P.
"Details Matter: A Quality Improvement Study on Screening for Intimate Partner Violence at a Labor and Delivery Hospital,"
Journal of Applied Research on Children: Informing Policy for Children at Risk: Vol. 11:
1, Article 5.
Available at: https://digitalcommons.library.tmc.edu/childrenatrisk/vol11/iss1/5