title: Referral patterns and service utilization in a pediatric hospital-wide intimate partner violence program.
abstract: OBJECTIVE
  To describe the referral patterns and utilization of on-site intimate partner violence (IPV) services in both inpatient and outpatient settings at a large urban children's hospital.
  
  
  METHODS
  Retrospective review of case records from IPV victims referred to an on-site IPV counselor between September 2005 and February 2010. Descriptive statistics were used to examine IPV victim demographics, number of referrals per hospital department, referral source (type of staff member), time spent by IPV counselor for initial consultation, and services provided to IPV victims.
  
  
  RESULTS
  A total of 453 unique referrals were made to the IPV counselor: 81% were identified by universal screening and 19% by risk-based screening. Thirty-six percent of IPV victims were referred from primary care clinics; 26% from inpatient units; 13% from outpatient subspecialty clinics; 12.5% from the emergency department; 5% from the Child Protection Program; and 4% were employee self-referrals. Social workers generated the most referrals (55%), followed by attending physicians (17%), residents (13%), nurses (7%), and other individuals (self-referrals) (4%). The median initial IPV intervention required 42 minutes. Supportive counseling and safety planning were the services most often utilized by IPV victims.
  
  
  CONCLUSIONS
  IPV screening can be successfully integrated in both inpatient and outpatient settings by a multidisciplinary group of hospital staff. Most referrals were generated by universal screening outside of the primary care setting. IPV victims generally desired supportive counseling and safety planning over immediate housing relocation. Many IPV screening opportunities were missed by using verbal screening alone.
authors.affiliation: Section of General Pediatrics, Center for Child and Adolescent Health, St. Christopher's Hospital for Children, Philadelphia, PA 19134, USA.
authors.forename: Mario
authors.initials: M
authors.lastname: Cruz
authors.forename: Patricia B
authors.initials: PB
authors.lastname: Cruz
authors.forename: Christine
authors.initials: C
authors.lastname: Weirich
authors.forename: Ryan
authors.initials: R
authors.lastname: McGorty
authors.forename: Maria D
authors.initials: MD
authors.lastname: McColgan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002649:Child Abuse / Q000523:psychology; D003376:Counseling / Q000706:statistics & numerical data*; D017579:Domestic Violence / Q000523:psychology; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007396:Internship and Residency; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D012017:Referral and Consultation / Q000639:trends*; D012189:Retrospective Studies; D012747:Sexual Partners / Q000523:psychology; D013179:Spouse Abuse / Q000628:therapy*; D055815:Young Adult
keywords: Child abuse; Domestic violence; Intimate partner violence; Residency; Screening