Team Approach for decreasing injuries related to Intimate Partner Violence (DIIPV)
Last updated
Share PrintThe activation and implementation of the National Relationship Health & Safety screening tool will help to identify those individuals who may be experiencing, or at risk for Intimate Partner Violence. The use of the RH&S screening tool throughout the JBVAMC will give the Veterans a chance (or chances if staying multiple days) to engage in conversations about their relationships health and safety. This in turn will assist the staff in early recognition of issues which may require intervention.
Origin:
January 2020, Jesse Brown Department of Veterans Affairs Medical Center (Chicago, Illinois)
Adoptions:
1 successful
Recent Updates
Overview
The problem
Intimate Partner Violence(IPV)/Domestic Violence(DV) is a preventable public health crisis, with an estimated 2.1 trillion in medical costs, and 1.3 trillion in productivity loss among those experiencing and using violence . According to the CDC 1:4 women and 1:7 men report experiencing severe physical violence by an intimate partner in their lifetime . Res
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Intimate Partner Violence(IPV)/Domestic Violence(DV) is a preventable public health crisis, with an estimated 2.1 trillion in medical costs, and 1.3 trillion in productivity loss among those experiencing and using violence . According to the CDC 1:4 women and 1:7 men report experiencing severe physical violence by an intimate partner in their lifetime . Research suggests Veterans and active duty Service members may be at higher risk than civilian counterparts , with IPV/DV across military populations ranging from 13.5%-58%. Although there is insufficient data to identify the statistical increase during the COVID pandemic, surges in IPV/DV during quarantine have been widely discussed . While less people were able or willing to leave their homes, and opportunities to reach out for help diminished, the point of contact which remained consistent for help-seekers was the medical field.
Given Jesse Brown’s commitment to a High Reliability Culture and despite pandemic demands, we decided to roll-out the IPV screening due to increased safety risks for Veterans. In rolling out the IPV screening, we can now engage in conversations with the veterans about their relationships health and safety for early detection of issues which may need intervention. See more
Given Jesse Brown’s commitment to a High Reliability Culture and despite pandemic demands, we decided to roll-out the IPV screening due to increased safety risks for Veterans. In rolling out the IPV screening, we can now engage in conversations with the veterans about their relationships health and safety for early detection of issues which may need intervention. See more
The solution
The National Intimate Partner Violence Assistance Program screening tool developed in 2019 called the Relationship Health & Safety (RH&S) Screening was activated as a clinical reminder and implemented to be used universally during the triage, intake and admitting periods of a Veterans visit.
The results
Prior to the rollout of the RH&S screening tool as a universal clinical reminder, 74 Veterans were screened for Intimate Partner Violence. At the conclusion of the rollout, 1767 Veterans were screened for Intimate Partner Violence - a 2050% increase.
Although the RH&S screening tool is a required clinical reminder, due to the complexities and safety con ... Prior to the rollout of the RH&S screening tool as a universal clinical reminder, 74 Veterans were screened for Intimate Partner Violence. At the conclusion of the rollout, 1767 Veterans were screened for Intimate Partner Violence - a 2050% increase.
Although the RH&S screening tool is a required clinical reminder, due to the complexities and safety concerns related to IPV/DV, staff training and education must precede its execution, which could take time and requires support from leaders and staff. As COVID health precautions continued and mainstream media sounded the alarm about quarantine/isolation related DV increases, our highly motivated Nurse Managers and clinic teams identified the urgency of RH&S screening roll-out despite the demands of the growing pandemic. As a secondary gain, Social Work and Nursing have developed closer collaborative relationships focusing on better patient/staff safety, care outcomes, environmental safety, and access to care. Overall, staff gained a better understanding how IPV prevention and intervention is directly related to our investment in High Reliability and the mission to improve health and well-being, which has helped us recommit to continuous improvement in creating a collaborative culture of safety and positive outcomes for all our Veterans and staff. See more
Although the RH&S screening tool is a required clinical reminder, due to the complexities and safety con ... Prior to the rollout of the RH&S screening tool as a universal clinical reminder, 74 Veterans were screened for Intimate Partner Violence. At the conclusion of the rollout, 1767 Veterans were screened for Intimate Partner Violence - a 2050% increase.
Although the RH&S screening tool is a required clinical reminder, due to the complexities and safety concerns related to IPV/DV, staff training and education must precede its execution, which could take time and requires support from leaders and staff. As COVID health precautions continued and mainstream media sounded the alarm about quarantine/isolation related DV increases, our highly motivated Nurse Managers and clinic teams identified the urgency of RH&S screening roll-out despite the demands of the growing pandemic. As a secondary gain, Social Work and Nursing have developed closer collaborative relationships focusing on better patient/staff safety, care outcomes, environmental safety, and access to care. Overall, staff gained a better understanding how IPV prevention and intervention is directly related to our investment in High Reliability and the mission to improve health and well-being, which has helped us recommit to continuous improvement in creating a collaborative culture of safety and positive outcomes for all our Veterans and staff. See more
Metrics
- 10/1/20 – 4/25/21: 573 Veterans agreed to screening (92F/481M), 429 Veterans were provided IPV education (80F/349M) , 4 Veterans were directly connected with emergency domestic violence shelter, and 75 Veterans were referred to the Intimate Partner Violence Assistance Program for safety planning, services, and support.
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Implementation
Timeline
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4-10 months
Jan 2019: Directive 1198 requires all VA's to develop IPV Assistance Program and implement IPV screening protocolJan 2020 – Oct 2020: RH&S screening preparation, finalizing local clinical reminder in CPRS, developing screening response protocol, developing and producing training materials for staff and IPV education/resource materials for Veterans, collaborating with clinic leadership and teams to determine commencement and trajectory of screening roll-out.October 2020: Train WHC staff to conduct and respond to screeningNovember 2020: WHC implementing screeningDec 2020-Feb 2021: Assess RH&S screening execution, success and needsMarch 2021: Train PACT clinic staff to conduct and respond to screening- same-day implementationApril 2021: Train ED clinic staff to conduct and respond to screening – same-day implementationChart review to monitor completion and accuracy of completed screening templates.
Departments
- Admissions
- Emergency care
- Nursing services
- Primary care
- Women Veteran care
Core Resources
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Contact
Comment
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Email VHACHSTeamApproachIPV@va.gov with questions about this innovation.
About
Origin story
The mission of Jesse Brown VAMC is “To honor American’s Veterans by providing exceptional health care that improves their health and well-being.” The last words of the mission, Well-Being , are directly affected by Intimate Partner Violence. If veterans are afraid or unsafe in their relationships, their mental, emotional, and physical health is greatly impac
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The mission of Jesse Brown VAMC is “To honor American’s Veterans by providing exceptional health care that improves their health and well-being.” The last words of the mission, Well-Being , are directly affected by Intimate Partner Violence. If veterans are afraid or unsafe in their relationships, their mental, emotional, and physical health is greatly impacted. Veterans presenting for routine care or to treat an injury may not volunteer information related to their relationships health and safety, and often do not identify what they are experiencing as unsafe. Failing to ask questions related to relationship health and safety leads to missed opportunities by health professionals to capture Veterans who may need help. By conducting the National RH&S screening universally when triaging and admitting veterans, we are providing a safe, non-judgmental opportunity for Veterans to disclose abuse, receive immediate education, intervention, and linkage to supportive services, thereby reducing barriers to care.
Original team
Misa Lopez
IPV Assistance Program Coordinator, Social Worker
Diane Haynes
Nurse Manager, Primary Care Clinics
Kristen Debits
Nurse Manager, Emergency Services
Awesome example of teamwork and dedication!
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