Effective Health Care
Response to IPV

 
P r o t o c o l s

Protocols can support health care teams and ensure a consistent response to intimate partner violence that protects that safety and wellbeing of both patients and clinicians. The Joint Commission on the Accreditation of Health Care Organizations requires accredited organizations to have a domestic violence protocol.

Below find the minimal requirements for an effective IPV protocol, as recommended by the Family Violence Prevention Fund.  If you are interested in further information, or in obtaining sample protocols from other facilities across the country, contact the Fund and they will send you a free resource packet. (Go to: www.endabuse.org/programs/healthcare, click on Technical Assistance and scroll down for available free packets.)

The following information is excerpted from the excellent manual Improving the Health Care Response to Domestic Violence: A Resource Manual for Health Care Providers, by Carole Warshaw, M.D. and Anne L. Ganley, Ph.D. à chapter 4. Also check appendices C and E for model protocols. Available online or order a hard copy.(http://endabuse.org/programs/healthcare/files/trainersmanual)

Protocols should include:

1. Definitions. Include the various manifestations and types (physical, sexual, psychological) of abuse and who (adult, adolescent, elderly, lesbian/gay) is covered by the policies.

2. Screening Procedures. Information should be available to clinicians either within the protocol or as an addendum addressing how to ask about abuse directly, including sample questions. Specify who is to do the screening. Specify precautions for ensuring safety and confidentiality. (See: Screening)

3. Intervention Procedures. Include interviewing strategies, safety assessment and planning, and discharge instructions. Information should be available to clinicians either within the protocol or as an addendum to the protocol on assessment (sample questions and techniques) and intervention (supportive information to convey, referrals, patient education materials, etc.). (See: Assessment and Interventions)

4. State Reporting Requirements. Clarify the law(s), if any. Include procedures for the release of information to the proper authorities as required by law. (See: Reporting Requirements )

5. Collection of  Evidence and Photographs. Include procedures for the collection, retention and release of evidentiary materials; hospital procedures for taking in-house photographs and securing release forms. (See: Documentation )

6. Medical Record Documentation. Clearly delineate what is to be included in the medical record (e.g., a description of the injuries, coloration, size, use of a body map to indicate location of injuries, stated or suspected cause of injury, action taken by clinician, etc.). (See: Documentation )

7. Referrals. Include instructions regarding available resources, and how to make referrals to in-house staff, domestic violence programs, legal advocacy, children’s services or other appropriate community agencies. Keep phone numbers updated on a regular basis. (See: Resources and Links for Health Care Providers )

8. Plan for Staff Education. All health care personnel should receive training, including hospital security. The Joint Commission on the Accreditation of Health Care Organizations (JCAHO) requires a staff education plan. (See: Education and Training)

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