Assault Programs Research Articles

Optimizing Interdisciplinary Care of Pediatric Sexual Assault and Abuse in the Emergency Department: A Quality Improvement Approach

The Ann & Robert H. Lurie Children's Hospital of Chicago identified issues with team communication, consistency of services provided, and continuity of care within the sexual abuse and assault program in the emergency department (ED) which necessitated improvement efforts. The aim of this project was to engage an interdisciplinary team to define and delineate roles and streamline clinical workflows from ED presentation to nonacute follow-up. An interdisciplinary team was convened and utilized quality improvement methodology to complete a current state analysis, develop a future state design, and prioritize interventions for improvement. The project team focused on four interventions: (1) establish a team approach with delineated roles and responsibilities; (2) develop and implement consistent workflows to reduce unwarranted variation in care; (3) expand education on the sexual assault nurse examiner (SANE) program more broadly to the care teams in the ED; and (4) implement clinical decision support (CDS) tools to streamline the continuum of sexual assault services provided. Three of the interventions (all but education) were carried out as a comprehensive care guideline for patients presenting to the ED for evaluation. The ED implemented this care guideline in August 2019. The utilization of quality improvement methodology was effective in ensuring an organized, interdisciplinary team response for the evaluation of pediatric and adolescent sexual abuse and assault in the ED. It enabled strong buy-in from team members and ownership of the process with anticipated improvements in patient care and experiences.

The historical roots and future directions for military law and policies on rape and sexual assault

ABSTRACTThe time in which rape has been a crime tried in the military criminal justice system is remarkably short. For much of the nation’s history, military members accused of common law crimes were tried in civilian courts established under Article III of the Constitution. The exception was during periods when the nation was at war. A continuous jurisprudence of military rape law did not begin until the late 1980s. Since that time, an avalanche of sexual assault scandals, legislation, task forces, and commissions have driven the issue to the forefront of public interest. While change was glacially slow for decades, the last 10 years have brought about some of the most dramatic changes in military justice since the Uniform Code of Military Justice (UCMJ) was established in 1950—changes driven almost entirely by the sexual assault debate. Congressionally chartered advisory committees like the Defense Task Force on Sexual Assault in the Armed Forces, the Response Systems to Adult Sexual Assault Crimes Panel, and the Judicial Proceedings Since Fiscal Year 2012 Amendments Panel have recommended many of the reforms to law and policy now in place regarding the military’s response to sexual assault allegations. Nonetheless, several key reforms are still waiting, including improved collection of sexual assault data and program performance metrics and a more precise definition in Department of Defense policy of what conduct constitutes sexual assault.

Victim Services, Community Outreach, and Contemporary Rape Crisis Centers

To evaluate proposals that independent rape crisis centers (SA) merge or add services, this article compares victim services and community outreach efforts of 16 North Carolina rape crisis centers: 8 SAs and 8 multiservice centers. The data raise serious questions about the ability of combined domestic violence/sexual assault(DV/SA) programs to reach sexual assault victims, to educate the community about sexual assault, and to work on rape prevention. DV/SA heard from far fewer sexual assault victims, including teenagers; did not routinely receive requests for hospital advocates; and did not provide systematic community education. SAs inform the community about sexual assault and develop strategies to change its knowledge and behaviors. SAs promoted inclusive definitions of sexual assault, incorporated cultural concerns in assessing their services and outreach, and initiated community education programs targeted at young people and males.