| Description |
Background: Intimate Partner Violence (IPV) remains a significant public health concern and is often overlooked in primary care settings despite the proven benefits of early identification and intervention. Even with professional organizations' recommendations, primary care screening rates remain low. Primary care settings are often patients' initial point of contact, presenting a critical opportunity for secondary prevention and access to supportive services. This project aimed to increase screening rates, promote universal education, and connect survivors to resources in a primary care setting. Local Problem: A local primary care clinic's complete lack of IPV screening revealed a significant healthcare system gap. This gap is influenced by various factors, including time constraints, provider discomfort, lack of education and training in abuse screening, unpreparedness to discuss IPV, unclear screening processes, and inadequate knowledge of resources for survivors. Methods: A pre-implementation survey and discussion were used to evaluate participants' IPV knowledge, perceived barriers, facilitators, and current workflow practice. A clinical practice guideline (CPG) was developed, incorporating a validated screening tool and educational resources. An educational presentation introduced the intervention. Biweekly in-person interviews with the clinic directors were conducted throughout the implementation period. A post-implementation survey and discussions evaluated the feasibility, usability, and acceptability. Descriptive statistics and thematic analysis were used to analyze pre and post-implementation qualitative and quantitative data. Interventions: A standardized screening workflow with patient education and resource provisions was implemented. The CPG outlined the standardized IPV screening workflow, including the roles and responsibilities of participants, the validated HARK screening tool, instructions for universal patient education utilizing Futures Without Violence safety cards, and a compilation of national and local resources. Results: Screening rates increased from 0% to 38%. Participants generally found the CPG to be feasible, useable, and acceptable. Satisfaction with the intervention was generally positive, with 78% (n=7) expressing satisfaction. However, only 22% (n=2) expressed a likelihood of continued guideline use. Integration of universal IPV education remained incomplete, while 100% (n=11) of identified positive screenings were connected to additional resources. Conclusion: This quality improvement project demonstrated improved IPV screening rates and successful connection of identified cases to additional resources. While participants generally perceived the CPG as feasible, usable, and satisfactory, the incomplete integration of universal IPV education and the reported unlikelihood of long-term sustainability highlights the need for further improvement. Future research should prioritize ongoing training and support for healthcare professionals, explore the feasibility of electronic screening modalities, and consider the development of a comprehensive pre-intervention toolkit for participants. |
