Unseen Intimate Partner Violence in the Emergency Department

Gwenyth Mercep ’22

Figure 1: Screening for IPV is not normative in the ED

Domestic abuse incidence is pervasive and tightly correlated with a large scope of disproportionate health disparities yet is largely underrepresented in data collection. Individuals who experience intimate partner violence (IPV) access the emergency department (ED) more often compared to their counterparts and most notably for chronic and long withstanding health conditions [1]. Despite guidance urging emergency medicine (EM) physicians to screen patients for IPV, strikingly low rates (4%-29%) of across the board screening prevail [1]. Hammock et al evaluate the effects of an educational session on EM physician’s attitudes toward IPV screening and succeeding IPV screening actions in the ED [1].

In 2012 a senior physician and renowned IPV expert-led an educational session for EM physicians regarding screening patients for IPV and providing IPV support services [1]. Surveys were carried out on physicians before and after the conference to assess their feelings towards IPV screening [1]. A bivariate analysis was done to test for variation in attitudes pre- and post-session [1]. A randomized medical record analysis was undertaken with patients eligible for IPV screening who were admitted to the ED and seen by any EM physician three months before and three months after the session [1]. Variation in IPV screening behavior with physicians who attended the educational conference (treatment group) versus physicians who did not attend (control group) was noted [1]. Essentially, the results suggest that the intervention was successful in improving physician awareness and knowledge of IPV, but was starkly unsuccessful in improving behavior or measurable healthcare outcomes [1]. 

Greater data availability surrounding IPV can lead to an improvement in outreach and policy for vulnerable populations. We must ensure that EM personnel feel capable to screen for IPV sensitively and thoroughly. With evidence indicating a lack of regularity with IPV screening in the ED, healthcare behavior and delivery modification requires thoughtful deliberation. Follow-up studies are needed to fully analyze the barriers in modifying screening behaviors to tailor future approaches for a range of potential health scenarios.

#screening #emergency #violence

[1]  A. Hammock, et al., “Evaluation of a short intervention on screening for intimate partner violence in an ED”, American Journal of Emergency Medicine 35, 171-173 (2017). DOI:

10.1016/j.ajem.2016.09.055[2] Image retrieved from: https://pixabay.com/vectors/doctor-physician-frame-medical-5135039/


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