This report presents the development, implementation, and evaluation of an intervention designed to improve the documentation of intimate partner violence (IPV) in medical records.
The medical records of victims seeking legal relief from IPV can provide a valuable source of information. However, current practices of medical documentation of IPV are inadequate and attorney use of medical records is under-utilized. As such, the current project builds on the previous work of a medical-legal, researcher-practitioner collaboration to develop a training protocol for a response to IPV that emphasizes documentation of the abuse, employs a patient empowerment model, and an interdisciplinary team approach. Focus groups were conducted with emergency medical technicians, paramedics, nurses, hospital administrators, advocates, social workers, and survivors of IPV from three study sites. This data, combined with a legal literature review on liability and patient privacy issues, were used to design a curriculum for a 50-minute training describing the benefits of health care response to IPV, presenting strategies for the assessment and documentation of IVP, and detailing a limited intervention response regardless of patient disclosure or readiness to take action. Several trainings were offered over a 3-month period at the study sites; evaluations of the training were conducted using medical records from both the pre-training and post-training periods. The evaluation results concerning training effectiveness were inconclusive because of the small number of medical records written by providers who attended the training. The findings that were analyzed indicated that the training increased provider identification of IVP. Recommendations for future work are identified, including the incorporation of training on how to discuss IVP with patients, the importance of gaining department-wide support, and the value of building interdisciplinary teams to respond to IVP. Future study should focus on identifying the strategies that will increase institutional investment for a consistent and effective IPV response in health care settings. Tables, references
Date Published: March 1, 2004