Identifying violence against persons at a safety-net hospital: Evidence from the first six months of implementation

OBJECTIVE: To examine the prevalence and predictors of screening for violence against persons and victim service utilization within an integrated safety-net health system. STUDY SETTING: Emergency Department (ED) at Parkland Hospital -- Dallas County's largest safety-net provider of services for minority and under-/un-insured patients. STUDY DESIGN: Prospective, longitudinal study during the first six-months of a universal violence against persons screener. DATA COLLECTION: Health records were extracted for all patients with a visit to the ED between January - July, 2021. Modeling described the patient population across screening (screened vs. not screened) and, among those screened, the results (positive vs. negative), average time spent in the ED, and referral patterns for victim services. PRINCIPAL FINDINGS: 65,563 unique patients with 95,555 encounters occurred during the study period. Seventy-one percent (n=67,535) were screened for violence against persons and, of those, 2% screened positive (n=1,349). Of patients that screened positive, 1,178 (87%) were referred to and 806 (60%) received care at victim services. Implementing screening did not increase ED length of stay. CONCLUSIONS: Systematic implementation of comprehensive violence screening at a safety-net system can result in a robust identification and timely referrals to victim services.