Intermountain Healthcare

Intimate Partner Violence (IPV) Screening and Intervention in the Outpatient Obstetrics/Gynecology (OB/GYN) Setting

Project Lead: Dr. Audrey Jiricko

Project AIM(s): Implement IPV screening among providers at select clinics across the Intermountain Healthcare system and connect patients to appropriate resources and referrals 

Narrative Description

Our project incorporated the following interventions:

  1. Incorporated the IPV screening tool as part of a clinical workflow into the EMR
  2. Identified and recruited 10 Intermountain clinics that primarily provide OB/GYN services to participate in the pilot project
    1. Original goal was eight pilot clinics; therefore, we exceeded the goal by two clinics. 15 clinics overall have been trained (at least 1% of providers screening).
  3. Fully trained healthcare professionals, including physicians, nursing staff, medical assistants, social workers, and patient services representatives, in each clinic that administers the screening

The project team found that implementation of IPV screening resulted in positive screening rates among patient populations that mirror national statistics. This suggests that, for the providers that are screening, the process is well-executed, and clinicians are having candid conversations with patients. These finding support the case for screening expansion and maintaining the same workflow that has already been established.  

There are numerous benefits associated with the implementation of a clinical workflow for the screening of IPV among Intermountain Healthcare patients, including improved rapport between providers and patients, enhanced organizational commitment to becoming a trauma-informed health system, increased referrals to domestic violence resources and services, and a larger focus on treating the whole patient versus a limited set of signs and symptoms. Although we haven’t engaged in any long-term evaluation of this work yet, there is a large body of evidence that supports the notion that addressing IPV early improves health outcomes and saves both the patient and the health system money. 

Participating in this opportunity proffered by SIDM has been a very positive experience. One of the most helpful aspects of being involved with this work is the support and peer-to-peer learning with other participating health systems. In the future, our team would enjoy more interactions with peers and learning about their efforts relevant to our IPV screening work.  

Diagnostic quality problem type, failure, or category (symptoms, observed problems, gaps in performance) addressed by the intervention

  • Patient delayed or unable to access to care
  • Information gathering
  • Information integration
  • Information interpretation
  • Establishing an explanation (diagnosis)
  • Communicating explanation to patient

Root causes/causative factors addressed by the intervention

  • Patient-clinician interaction (includes patient and family engagement)
  • Workflow (includes testing, follow-up, and referrals)
  • Health information sharing and accessibility via health IT
  • Knowledge gaps/inexperience

Setting of the diagnostic quality improvement intervention

  • Ambulatory medical care setting (e.g., clinic, office, urgent care)