Effect of an administrative intervention on rates of screening for domestic violence in an urban emergency department.
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.
Larkin
G L
GL
Department of Emergency Medicine, Mercy Hospital of Pittsburgh, Pa., USA. glarkin+@pitt.edu
Rolniak
S
S
Hyman
K B
KB
MacLeod
B A
BA
Savage
R
R
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