by Donald Wayne Clark, M.D.
Journal of the American Board of Family Practice
Vol 14, No. 4
2001

Reviewed by Loree Cook-Daniels

A newly-released study of Indian Health Service screening for domestic violence provides interesting clues on what does – and doesn’t – help health care organizations do universal screening for domestic violence cases.

The study by Donald Wayne Clark, M.D., “Domestic Violence Screening, Policies, and Procedures in Indian Health Service Facilities,” was reported on in the Journal of the American Board of Family Practice. Of the 142 facilities studied, 62% screen for domestic violence and 64% had policies and procedures for domestic violence. Those with policies and procedures were more likely to screen patients. Screening was done verbally (6.8% of facilities), in writing (45.5%), and via a combination of the two approaches (43.2%).

Facilities in 18 states reported that physicians have mandatory domestic violence reporting requirements, although different facilities in the same state answered in opposite ways. More than a fourth of the respondents (28.9%) did not know whether physicians in their state were mandated reporters, and an additional 39.7% did not answer the question. A perception that there was a mandatory reporting requirement had no effect on whether women were screened for domestic violence or not.

However, the Joint Commission for the Accreditation of Healthcare Organizations (JCAHO) 1992 requirement that hospitals and clinics have policies and procedures for domestic violence screening was perceived by 23.8% of the respondents as being “most important” in influencing a facility’s development of policies and procedures.

The background section of the article highlighted other little-known facts such as a study that found that “women randomly assigned to a community-based advocacy intervention experienced one half the risk of violence of women who did not receive these services,” and “a recent national survey of health maintenance organizations showed that 28% had policies, protocols, guidelines, or materials on screening for domestic violence.” The author also noted that “the National Committee for Quality Assurance does not track any indicators related to domestic violence despite the recommendations of professional organizations and growing evidence of positive outcomes after clinical intervention.”

Text of the article can be found at http://www.medscape.com/viewarticle/405855.