Domestic violence

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Improving the detection and management of Domestic Violence
(DV) in the Emergency Department through multidisciplinary
education and novel screening
Ealing Hospital 2013 - 2015
H Robertson, J Hanlon, A Thomson, S Halstead, S Jones, F Sackey, F Wisniacki
First and second authors contributed equally to this poster
The Homicide Review (2013) states that healthcare professionals
are not doing enough to safeguard victims from Domestic
Violence. It highlighted that professionals were poor at sharing
information and were often unsure of the correct process to
follow in cases of DV.
In recognition of this we set out to:
• Assess the existing approach to potential cases of DV in the
Emergency Department (ED).
• Improve the identification and management of cases of DV
presenting to the hospital’s ED
• Facilitate training and teaching of healthcare professionals.
Left, right and below: ‘useful contacts’
card, one-sheet screening form and
world-cup related awareness poster:
examples of the multiple ways we have
tried to improve standards.
Audit 1: Aug 12’-13’
Existing situation
Audit 2: Nov 14
DV teaching and
confidence
questionnaire
11
confirmed
DV
2290 cases
analysed
• 80% had experienced DV
• 95% felt confident after
teaching vs.65% before
1 referred to DV service
6 identified children at home
5 had other follow up
No further resources offered
A questionnaire also measured
current knowledge, barriers and
confidence
Audit 3: July-Oct 14’
Missed
opportunities of
screening
367 triggering
cases
56 attributed to
possible DV
One case had
been screened
using tool
1.
2.
Following our repeat audit in
December 2014, we found
disappointing uptake rates of our onesheet screening initiative, despite
informal teaching and promotion.
3.
New and exciting initiatives are now
underway, including regular,
organised multi-disciplinary staff
education to promote awareness and
use of the one-sheet screening.
6.
4.
5.
7.
8.
With kind permission from endthefear.co.uk
Greater Manchester against Domestic abuse
9.
Project themes
o Identification and
screening
o Staff education and
raising awareness
o Facilitating the referral
pathway
o Safeguarding
o Improving patient
safety
ACTIONS for Re-audit
Engagement of the urgent care centre
Accurate data capture of all victims of
assault to include those of DV
Opening of a Victim Support Service within
the hospital
Intensive training of all ED staff on the
screening tool and referral pathways for
DV including adequate documentation.
Ensure screening tool easily accessible to
department
Ensure ‘useful contacts’ card is available to
the public and provided where
appropriate.
Re-audit of questionnaire and form
following teaching
Focus Group discussion to consider new
initiatives to improve detection.
Re-audit May 2015
“New projects for uncommon presentations need continuous promotion, discussion and reflection
to really get them off the ground.” Coming soon: put a STOP with a DOT
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