Assessment of a community health center's interpersonal screening and referral program: Lessons learned in working to document and enhance the quality of care of survivors of violence

Survivors of interpersonal violence are frequent users of health care services. Recognizing that they are the gateway to care for many victims of violence, a multi-site community heath care center (CHC) in Massachusetts has made the screening and treatment of women who are victims of violence a health care priority for the past ten years. Concerned about the quality of care they offer patients, they recognized the need to assess and document their domestic violence program. They thus began collaboration with an academic group at the Boston University School of Medicine that works in this area. A critical but often missing piece of programs in this field is the integration of continuous quality improvement that focuses on: 1) the quality and level of responsiveness of the health care system to survivors of violence; and 2) measurement of the effectiveness of these programs in reaching survivors of violence. The assessment consisted of looking at: domestic violence polices and protocols; baseline levels of screening of and disclosure by patients; levels of documentation and services; patients' attitudes regarding screening; provider knowledge, attitudes and practices in this area, and the educational material offered to patients. The final product of the assessment is a report that outlines the findings, along with specific, practical suggestions as to how to improve screening and services. We will present our findings along with the assessment steps and tools which can be applied to groups working on or planning work in this field.