Pediatrics Resident Children's Hospital of Philadelphia Children's Hospital of Philadelphia Pediatrics Residency Program Philadelphia, Pennsylvania, United States
Background: Routine intimate partner violence (IPV) screening in the pediatric emergency department (ED) can offer the opportunity to effectively identify risks and provide appropriate interventions for families exposed to IPV. In light of the COVID-19 pandemic, IPV screening rates dropped substantially whereas the lethality of IPV cases increased.
Objective: Quality improvement research has demonstrated improvement in healthcare metrics such as communication and patient outcomes following the provision of individualized feedback tools. We utilized a similar model to improve caregiver IPV screening rates in the pediatric ED.
Design/Methods: Through an interdisciplinary effort, we developed a feedback tool that provided individualized quarterly feedback to ED nurses working in a large, pediatric academic center. The feedback tool included the quarterly department-wide screening rates, the nurse’s individual screening rates, and a list of common reasons for which screenings were deferred. We conducted quarterly PDSA cycles utilizing the feedback tool to test changes that would improve screening rates. The feedback tool was disseminated in July 2020 and in October 2020 via email and screening rates were tracked via QlikView® data analytics and integration software. Feedback from the initial PDSA cycle was incorporated in the next cycle and was further complemented by institutionalized sustainability efforts including bulletin boards and a reward competition for the highest screeners.
Results: Following our PDSA cycles in July and October 2020, screening rates increased from an average of 22.7% and 25.11% the seven weeks preceding to an average of 26.8% and 29.7%, respectively, the seven weeks following. Number of providers screening improved by 11% and 10% from an average of 62 and 68 the seven weeks preceding to 69 and 74, respectively, the seven weeks following. Overall, our median screening rate improved from an average of 21.2% to 29.2% following the implementation of the feedback tool. Referrals to IPV specialists increased from an average of 10 per month prior to the introduction of the tool to an average of 13 per month following. Conclusion(s): Individualized feedback tools can be used to improve IPV screening rates in the ED. Feedback tools are further enhanced by institutionalized sustainability efforts. Additional cycles as well as qualitative data collection are planned to test educational initiatives to improve knowledge and conduct additional observations of the screening process for quality control.
Intimate Partner Violence Screening Feedback Tool Example
Intimate Partner Violence Screening Rates Average Run Chart
Authors/Institutions: Priyanka Joshi, Children's Hospital of Philadelphia Pediatrics Residency Program, Philadelphia, Pennsylvania, United States; Katherine Obenschain, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States; Kimberly J. Anderson, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States; Ashlee Murray, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States