A Mixed Methods Evaluation of a Model of Care for Domestic Violence Within the Emergency Department.

Abstract

Objective: To describe the scope and extent of the Domestic Violence (DV) Model of Care at Campbelltown Emergency Department (ED). We detail patient population characteristics, means of identifying victim-survivors, care provided, and factors associated with social work review.

Methods: This mixed-methods evaluation utilised (1) retrospective audits of medical records of patients admitted to Campbelltown ED in 2024, who (a) responded affirmatively on the DV Routine Screening (DVRS) tool, and/or (b) were reviewed by social work relating to DV; and (2) semi-structured interviews with 19 clinicians and support workers about their understanding of and role within the model of care. Descriptive analyses quantified the scope and characteristics of the DV patient population and care provision; logistic regression identified factors associated with DVRS-identified patients seeing social work. Thematic analysis of interview data supplemented audit findings.

Results: In 2024, 249 ED patients responded affirmatively to the DVRS tool (DV identified prior for 52.2%), and 231 patients were reviewed by social work relating to DV. Victim-survivors were identified through DVRS tool use, explicit disclosure, referral from community partners, and clinician judgement. Transfer to the ED short stay unit facilitated safety and trauma/violence-informed care, including social work consultation for 49.8% of identified victim-survivors. Explicit disclosure or help-seeking, presenting concerns, and child safety risks were associated with seeing social work; however, presentation day/time was not.

Conclusions: This evaluation demonstrates that a comprehensive ED model of care, employing multiple means of identifying victim-survivors, is able to facilitate trauma/violence-informed psychosocial care alongside medical management for patients experiencing DV.