Universal, trauma-informed education represents a major shift from traditional public health models of screening for domestic violence. Compared with direct disclosure based screening, patients and health care providers respond favorably to a universal education approach. As a physician assistant working in our busy pediatric emergency department at Connecticut Children’s, and one who has experience using the traditional domestic violence screening method, I can see the benefits of this different approach.
The universal education approach involves the use of educational materials as tools to deliver standard messaging about domestic violence and its impact on health to patients, regardless of any previous disclosure of domestic violence. This approach also serves to link patients with local, free, and confidential domestic violence resources.
Building on the domestic violence screening experience in our pediatric surgery clinic, the Children’s Center on Family Violence is planning to implement a universal domestic violence education and optional screening model for caregivers of children seen in several ambulatory clinics at Connecticut Children’s Medical Center. This setting offers the potential to serve as a key point of entry into services for DV victims, which comprise a substantial proportion of patients.
This initiative will have components of education, screening, service connection and will be piloted as a clinical quality improvement initiative in multiple outpatient settings including our Emergency, Orthopedic, Surgery, Pulmonary, and Endocrinology Departments at Connecticut Children’s Medical Center. It will include a focus on supporting children’s resiliency by building protective factors, use a universal education approach for engagement, and offer families multiple options for connection to domestic violence advocacy services.
For those who do not elect to engage the social worker/health care team in the discussion, the results of screening and/or choice to connect directly to domestic violence advocacy provider will be recorded anonymously and will not link to the patient’s chart. This approach will provide the caregiver with information and choices not previously available and provide the opportunity to link directly to DV advocacy services and/or the health care team for help.
If victims select the online text chat option, they will receive the same one-on-one, real-time, confidential information from a certified advocate as they would by phone or in person. This is not a public chat room and the session is completely confidential and anonymous.
All hospital social workers responding to outpatient settings in the institution will participate in response to families electing to speak with a social worker. The development of pediatric education cards highlighting children’s exposure to domestic violence will be made available to all hospital social workers and staff in clinic areas to assist these conversations.
Stay tuned for updates regarding this very interesting and exciting work.