Patient-centered intimate partner violence screening, brief intervention, and referral to treatment

OBJECTIVE: To increase rates of screening for intimate partner violence (IPV), education, and follow-up of women being seen at a private obstetrics and gynecology clinic to 52% in 90 days. DESIGN: Quality improvement project. SETTING/LOCAL PROBLEM: IPV screening was not the standard of care at a private suburban obstetric and gynecologic practice. METHODS: This project used an evidence-backed model for improvement that incorporated plan-do-study-act cycles to implement four core interventions. INTERVENTIONS: The Hurt, Insult, Threaten, Scream (HITS) screening tool, the investigator-developed Duluth model tool, a case management log, and a team engagement plan were implemented. RESULTS: Implementation of the HITS screening tool was associated with an increase in IPV screening to 94.7% from a baseline of 2.5%. In addition, the IPV disclosure rate increased 7.5% over the course of the initiative. The majority of staff (64%) participated in IPV educational offerings, and an increase in IPV knowledge was noted in team surveys, on which scores increased from 68% to 76.9%. CONCLUSION: The combined use of the HITS screening tool and the Duluth model tool were associated with increased rates of IPV screening. Women who screened positive for IPV were referred to appropriate resources. These findings can be used as a guide for clinics to implement IPV screening into practice.