The 130th Annual Meeting of APHA

Abstract #49472

Consuelo Dungca, RN, EdD and Suyapa Villalobos, RN. Office of Clinical Affairs, NYC Health and Hospitals Corporation, Office of Clinical Affairs, Central Office, 125 Worth Street , Suite 427, New York, NY 10013, 212 7883307, dungcac@NYCHHC.ORG

Learning Objectives: New York City Health and Hospitals Corporation (NYCHHC) has a long history of dealing with the complex problems of domestic violence dating back to the early 1990's. In April 1994, the City embarked upon two major initiatives designed to confront domestic violence as a public epidemic. The Department of Health and the HHC initiated a program to identify, treat and track domestic violence victims who enter the health care system. A tracking form is implemented to gather data on survivors and identify opportunities for improvement in care. Domestic violence is a significant social and medical problem affecting the residents of NYC and specifically HHC patients. Early recognition plays a major part in reducing deaths from domestic abuse. When properly educated, health care professionals take every opportunity to assist victims of abuse. The care givers’ expressed compassion and willingness to help provides the victims a sense of security. Thus, the health care system is a critically important source of support. Through intensive ongoing training, health care professionals are more knowledgeable of the problem. They are able to identify abuse and intervene earlier in breaking the cycle of domestic violence. Early screening and intervention can lead to a more positive outcome. __________________________________________________ 2 Page Summary BACKGROUND Domestic violence is a crime of enormous magnitude and tragic consequences in our society. Domestic violence is about power and control that a person exercises over another that physically harms, induces fear, or forces a person to act in a way that they do not wish to act. Domestic violence often begins with non-violent forms of abuse and control, escalating when the abuser does not feel “enough” in control. Because there is a sense of “winning” either verbally or physically, the abuser will change his tactics over time to gain control. When the abuser feels control of the victim or other things in life slipping away, he may employ even more drastic measures. Normal behavior becomes the “in-between” periods when the abuse is absent. However, the situation never is normal. Unfortunately, women are willing to forgive the first beating, considering it an anomaly rather than a warning signal of future abuse. OBJECTIVES

At the end of the presentation, the participants will be able to
• Describe the importance of having dedicated, trained Domestic Violence Coordinators assigned in acute care facilities and diagnostic and treatment centers to managed survivors. 2) Identify the information required to have an effective Domestic Violence Tracking Form. 3) Discuss the effectiveness of a standardize best practice guidelines in the management of domestic violence survivors. METHODOLOGY
  The NYCHHC domestic violence initiative started in April 1994 with the implementation of comprehensive domestic violence policies and procedures at all facilities to sensitize staff, increase identification and prevent further abuse and injury to domestic violence victims. HHC has dedicated Domestic Violence Coordinators at the eleven acute care hospitals and six Diagnostic and Treatment Centers. The Coordinators serve as the domestic violence experts for each facility providing in-house training, compliance with domestic violence policies and procedures, referrals, counseling, outreach and promoting hospital linkages with community resources. Effective screening, identification and tracking of victims in the Emergency Departments is made through the use of two screening questions on the Emergency Room encounter form. These questions have ensured universal screening for domestic violence and is readily retrievable through the computerized billing system. Once the patient responds affirmatively to experiencing domestic violence, treatment and appropriate referrals are made. The Domestic Violence (DV) tracking form is completed. These forms are send to HHC Central Office for analysis, comparison from different acute care facilities. Based on the data collected, opportunities for improvement of care and referrals in the management of DV cases are made. RESULTS
  In Calendar Year 2000 HHC facilities have provided services to 3,790 domestic violence patients as compared to 2,924 in Calendar Year 1999, an increase of 866 cases. The mechanism which was implemented to identify and provide early intervention to DV survivors has proven to be successful. CONCLUSION
  This program has seen the successful implementation of the Domestic Violence Coordinators and the Domestic Violence standardized tracking form. The Domestic Violence Coordinators facilitate the services to the victims and the tracking form provides important information on demographics, incidence of domestic violence in the communities and information on how HHC can identify opportunities to enhance their Domestic Violence programs in every facility. HHC will soon be issuing a family violence protocol that will address how to respond to and treat victims of domestic violence, child abuse, rape/sexual assault and elder.

  Keywords: Battered Women, Domestic Violence

  Presenting author's disclosure statement:
  I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

  L. After the Storm: Women Surviving Violence

  The 130th Annual Meeting of APHA