Intimate Partner Violence Programs in a Children's Hospital: Comprehensive Assessment Utilizing a Delphi Instrument.
OBJECTIVE
The purpose of this study was to conduct a baseline assessment of intimate partner violence (IPV) practices in a pediatric hospital system.


METHODS
The Delphi Instrument for Hospital-based Domestic Violence Programs was used to assess the structure and components of the hospital system's IPV practices. Through key stakeholder interviews, we also assessed IPV practices in individual patient care areas. Qualitative analysis of interview data used a grounded theory approach.


RESULTS
The hospital scored 17 of 100 points on the Delphi instrument assessment. Key areas of weakness identified by the Delphi instrument and interviews included lack of coordinated provider training and evaluation of IPV-related processes and no standards for IPV screening, safety assessment, and documentation. Most interviewees supported addressing IPV; all identified barriers to IPV screening at individual provider and institutional levels. Institutional barriers included lack of a standardized response to IPV disclosure, need for individualized screening protocols for different patient care settings, lack of standardized provider training, concerns about overextending social work resources, and lack of resources for hospital staff experiencing vicarious trauma. Individual barriers included concern that screening may harm physician-patient-family relationships and the perception that physicians are unwilling to address psychosocial issues.


CONCLUSIONS
The Delphi Instrument for Hospital-based Domestic Violence Programs identified weaknesses and key areas for improvement in IPV practices. Deficiencies revealed by the Delphi instrument were affirmed by individual interview results. Institutional and individual provider level barriers must be addressed to optimize IPV practices in a pediatric hospital system.
Division of Emergency and Urgent Care; and karandell@cmh.edu.
Kimberly A
KA
Randell
Division of Developmental and Behavioral Sciences, The Children's Mercy Hospital, Kansas City, Missouri.
Sarah E
SE
Evans
Division of Emergency and Urgent Care; and.
Donna
D
O'Malley
Division of Emergency and Urgent Care; and.
M Denise
MD
Dowd
D000061:Accidents, Home / Q000517:prevention & control*; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002649:Child Abuse / Q000517:prevention & control*; D003144:Communication Barriers; D003697:Delphi Technique; D030881:Disclosure / Q000592:standards*; D017579:Domestic Violence / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data; D005069:Evaluation Studies as Topic; D005260:Female; D006301:Health Services Needs and Demand; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D015146:Midwestern United States; D018570:Risk Assessment; D012948:Social Work Department, Hospital / Q000706:statistics & numerical data; D000078329:Workforce
intimate partner violence; pediatric hospital; screening; trauma