title: Effect of an administrative intervention on rates of screening for domestic violence in an urban emergency department.
abstract: OBJECTIVE
  This study measured the effects of an administrative intervention on health care provider compliance with universal domestic violence screening protocols.
  
  
  METHODS
  We used a simple, interrupted-time-series design in a stratified random sample of female emergency department patients 18 years or older (n = 1638 preintervention, n = 1617 postintervention). The intervention was a 4-tiered hospital-approved disciplinary action, and the primary outcome was screening compliance.
  
  
  RESULTS
  Preintervention and postintervention screening rates were 29.5% and 72.8%, respectively. Before the intervention, screening was worse on the night shift (odds ratio [OR] = 0.46, 95% confidence interval [CI] = 0.31, 0.68) and with psychiatric patients (OR = 0.34, 95% CI = 0.14, 0.85); after the intervention, no previous screening barriers remained significant.
  
  
  CONCLUSIONS
  An administrative intervention significantly enhanced compliance with universal domestic violence screening.
authors.affiliation: Department of Emergency Medicine, Mercy Hospital of Pittsburgh, Pa., USA. glarkin+@pitt.edu
authors.forename: G L
authors.initials: GL
authors.lastname: Larkin
authors.forename: S
authors.initials: S
authors.lastname: Rolniak
authors.forename: K B
authors.initials: KB
authors.lastname: Hyman
authors.forename: B A
authors.initials: BA
authors.lastname: MacLeod
authors.forename: R
authors.initials: R
authors.lastname: Savage
mesh_terms: D000328:Adult; D004636:Emergency Service, Hospital; D004638:Emergency Treatment / Q000451:nursing*; D004647:Employee Discipline / Q000379:methods*; D005260:Female; D019983:Guideline Adherence; D006786:Hospitals, Urban; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D009551:Night Care / Q000592:standards; D009730:Nursing Assessment / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000193:education* / Q000523:psychology; D016017:Odds Ratio; D016134:Organizational Policy; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D013179:Spouse Abuse / Q000175:diagnosis*; D014193:Trauma Centers