Robert Wood Johnson University Hospital – Domestic Violence Program

Domestic violence is a major public health concern that affects four to six million relationships each year in the United States. When victims are restricted and controlled by their abuser, one of the few places they are able to go is to their health care provider. For this reason, health care providers have a unique opportunity to reach victims and support them, before the abuse escalates to serious injury, lifelong health consequences, or death. It is estimated that 24 percent to 54 percent of all women who visit emergency departments (EDs) have been abused during their lifetime, and it is suggested that victims utilize the health care system as much as 2.5 times as often as non-abused patients.

Overview

Domestic violence is a major public health concern that affects four to six million relationships each year in the United States. When victims are restricted and controlled by their abuser, one of the few places they are able to go is to their health care provider. For this reason, health care providers have a unique opportunity to reach victims and support them, before the abuse escalates to serious injury, lifelong health consequences, or death. It is estimated that 24 percent to 54 percent of all women who visit emergency departments (EDs) have been abused during their lifetime, and it is suggested that victims utilize the health care system as much as 2.5 times as often as non-abused patients.

Health care professionals can address domestic violence by identifying victims, offering support and referring patients to community agencies. Unfortunately, health care professionals face a myriad of personal barriers, job-related barriers, and patient-related barriers that can hinder their ability to effectively identify and assist victims. RWJ New Brunswick and the New Brunswick Domestic Violence Awareness Coalition created and implemented a model training program called “Domestic Violence and the Role of the Healthcare Provider: Assessment and Intervention Strategies” (DV Program) to address the lack of training and/or educational opportunities on this topic for health care providers. The goal of this program is to train health care providers to identify, screen and act as resources for their patients.

Impact

The DV Program has trained 1,872 health care providers since 2012 in New Jersey, Missouri, and Florida. Health care providers learn about the dynamics of abusive relationships and the clinical signs of abuse. The training also addresses other personal and societal barriers such as prejudices and problems identifying with victims; institutional barriers such as lack of support, resources, and collaboration with community agencies; and professional barriers such as lack of education, training and tools. In 2013-14, 95 percent of the 427 providers reported a commitment to screening for domestic violence-related health issues following the training; 98 percent reported increased knowledge/awareness about screening for DV; and 66 percent reported implementing DV screening into their practice. Approximately 8,700 patients on a weekly ongoing basis potentially benefited from implementation of the training.

Lessons Learned

Program leaders have learned that providing continuing education units increases attendance. During year one, they had continuing education for nurses; in year two, they added CME for physicians, and saw the numbers of physicians in attendance rise significantly. In year three, they added social work CEUs. In addition, program leaders learned that the role-play exercise, in tandem with the presentation, is a valuable tool for providers to reinforce what they learned and be ready to put it into practice.

Future Goals

Program leaders hope to add continuing education for EMS personnel, to tailor the presentation for Maternal and Child Health Consortium programs, and to expand to other states, thereby continuing to expand their reach to health care providers and their patients.

Contact: Michael Knecht
Senior Vice President, Strategic Marketing and & Communications
RWJBarnabas Health
Telephone: 732-937-8521
Email: michael.knecht@rwjuh.edu