Hospital Policy and IPV Patients: Bridging the Disconnect

Objective: This study examines intimate partner violence policies currently impmlemented in the emergency departments (EDs) of a southern state. It assesses the extent to which the policies are congruent with JCAHO standards and with a model policy developed by the state department of health. It also examines the effect of hospital characteristics on policy quality.

Methods/Design: Participants provided their policies regarding IPV and other forms of violence. Review criteria were developed based upon JCAHO standards, the model policy and best practices. Review procedure followed that of a similar study performed in Connecticutt. Hospital characteristics were obtained from publicly available datasets.

Sample studied: 61 EDs participated (RR 75%). These are similar to other state EDs in terms of bed size, system membership (61%), structure (75% not-for-profit) and location.

Results: Almost none (2%) of the policies fully address IPV or reference JCAHO standards. Only 5% use a comprehensive definition of IPV; over one-third (36%) provide no definition. A few (8%) routinely assess all patients for IPV. One fifth discuss safety assessment, but almost none (5%) incorporate a lethality assessment. While 71% mention documentation, only half provide protocols. Only 25% correctly state the reporting requirements for IPV. Only one-third of EDs require IPV training. Hospital characteristics were generally not related to the quality of the policy.

Conclusions: The majority of EDs in do not have comprehensive policies in place to guide the treatment of IPV patients. Without such policies, it is unlikely that comprehensive changes in the treatment of IPV victims will occur.