Intimate Partner Violence and Emergency Department Screening: Computerized Screening Versus Usual Care

Abstract

To compare a computer-based method of screening for intimate partner violence (intimate partner violence) with usual care in an emergency department (ED) setting. During 3 distinct but consecutive 2-week periods, women who presented to the ED were asked to complete a computer-based health survey with or without intimate partner violence screening questions in addition to receiving usual intimate partner violence care (ie, screened voluntarily by ED providers and documented in medical record). The screening, detection, referral and service rates were compared between women who completed the computer-based health survey with the intimate partner violence screening questions to usual care. Of the 411 women who completed the computer-based health survey with the intimate partner violence questions, 99.8% were screened for intimate partner violence compared to 33% of the 594 women who received usual care (67.1% difference; 95% CI 63.3%, 70.9%). The computer-based health survey detected 19% intimate partner violence positive whereas usual care detected 1% (17.8% difference; 95% CI 13.9%, 21.7%). Referral to social work was higher among those screened by the computer-based health survey (10%) versus usual care (<1%) (9.7% difference; 95% CI 6.7%, 12.7%). Only 20 subjects received intimate partner violence services, although it was slightly higher among those screened by the computer-based health survey (4%) compared to usual care (1%) (4.0% difference; 95% CI 2.0%, 6.1%). We found that a computer-based approach led to significantly higher intimate partner violence screening and detection rates compared to usual care. Receipt of intimate partner violence services was also higher than usual care but was not optimal. Computer technology makes routine screening easier and allows us to redirect our energies to addressing patients' intimate partner violence problems.