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Universal Intimate-Partner Violence Assessment in the Pediatric Emergency Department and Urgent Care Setting

A Retrospective Review

Litzau, Megan MD*; Denise Dowd, M. MD, MPH†‡; Stallbaumer-Rouyer, Jennifer MSW, LCSW§; Miller, Melissa K. MD†‡; Randell, Kimberly A. MD, MSc†‡

doi: 10.1097/PEC.0000000000001635
Original Article: PDF Only

Objective The aim of this study was to examine universal intimate-partner violence (IPV) assessment in the pediatric acute care setting.

Methods We reviewed universal IPV assessment over 1 year in 2 emergency departments and 3 urgent care centers within a children's hospital system. Written IPV assessment used 2 questions (ie, safety concerns at home, information desired); “yes” to either was considered positive. We identified positive assessments via preexisting quality report. We collected demographics, resource utilization, and reason for positive screen by chart review. Positive assessment for IPV was determined by chart documentation.

Results Intimate-partner violence assessment was documented in 169,399 visits (96% of all visits); 511 (0.3%) were positive. Four hundred ninety cases were reviewed; 21 cases were excluded (incomplete data). One hundred twenty positive assessments were classified as misunderstood (“yes” marked in error); these were associated with nonwhite race (P < 0.001). We identified IPV in 169 (46%) of the remaining 370 positive assessments. Intimate-partner violence identification was associated with white race (P = 0.004), female caregiver (P < 0.001), and English as primary home language (P = 0.045). Non-IPV concerns triggered 239 positive assessments; concerns included child maltreatment (n = 125), mental/behavioral health (n = 46), other violence (n = 33), and parenting (n = 21). Intimate-partner violence was identified by social work in 82 cases triggered by non-IPV concerns. Resources utilized included social work (99%), non-IPV resources (59%), IPV advocate (21%), law enforcement (0.8%), and child protective services (1.6%).

Conclusions Universal IPV assessment in the pediatric acute care setting is feasible and may enable resource provision for IPV and non-IPV concerns.

From the * University of Missouri–Kansas City School of Medicine;

Children's Mercy Kansas City;

Division of Emergency Medicine, University of Missouri–Kansas City School of Medicine; and

§ Department of Social Work, Children's Mercy Hospital and Clinics, Kansas City, MO.

Disclosure: The authors declare no conflict of interest.

Reprints: Megan Litzau, MD, 2679 Hayward Ave, Apt B, Brownsburg, IN 46112 (e-mail:

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