Hospital awarded for its model program
Hospital awarded for its model program
(Editor's note: This month's issue of Women's Health Center Management includes the second part of a two-part series on domestic violence and pregnancy. In last month's issue, we discussed the increased number of pregnant women affected by domestic abuse, which has led to miscarriage, premature labor, low-birth-weight delivery, substance abuse, and even death. Women's health centers are responding by educating their staffs on how to screen for domestic violence among pregnant patients and how to put systems in place for reporting abuse and referring victims to counseling. This month's issue covers one hospital's exemplary domestic violence program and another hospital's research into this disturbing trend.)
Sisters Hospital in Buffalo, NY, started a domestic violence program called Safe Passage in 1994, after an evaluation of women's health care needs in the community revealed a significant impact of violence on women's health.
Sisters established a task force to work with community resources. The hospital joined the Eerie County Coalition Against Family Violence and became an active member with a local shelter for battered women. The shelter helped them build a hospital-based program, called Safe Passage.
Safe Passage implemented an intense training program for everyone involved in patient contact. Now, it conducts annual mandatory training on the dynamics of abusive relationships, identification of domestic abuse, interview of the victim, and documentation.
As a result of its extensive efforts, the Safe Passage Program won the Civic Empowerment Award in 1997 from the All-America City awards. These awards are part of a program of the National Civic League, a nonprofit organization based in Denver that recognizes citizens' efforts in bettering their communities.
"Abused women enter the hospital system with complications at different points," says Kathleen Slammon, MSW, CSW, director of Safe Passage. Historically, we never asked about domestic violence - why is this person having abnormal bleeding or a spontaneous abortion? - because no one thought of it as a big problem. We didn't know what the common indicators were, so we thought it was stress or other medical problems."
Having a program in place produces a protocol throughout the entire hospital system so that once a victim is identified, the system can offer advocacy and information, such as including appropriate documentation in the medical record, teaching victims safety planning, and connecting them to community resources, Slammon says. "If there's no program, none of this would happen."
Sisters Hospital also offers 24-hour advocacy in the ED by utilizing volunteers and hospital social workers. In addition, the ED is redoing its nursing forms to address questions for routine screening for domestic abuse. And throughout the hospital, anyone suspected of domestic violence is seen by social workers before being discharged. Victims who have been discharged are followed up by a hospital social worker.
Since domestic violence starts or worsens during pregnancy, the hospital's Family Health Center does routine screening for violence history on all OB patients. "Once identified, we talk to victims about stress and the dangers of an abusive relationship, and what it does to the pregnancy," says Slammon. "We don't tell them what to do, but empower them to make their own decisions."
Filling a major gap in the community, the hospital bought and renovated a two-family home to provide a safe place for those leaving the battered women's shelter. Funding was provided by the city, the state of New York, and the hospital's foundation. In addition, Safe Passage held its first annual "Heal the Hurt" walk last year to raise money and awareness for the program.
The battered women's shelter provides tenants and case management. Women are responsible for rent - contributing 30% of their income - and utilities. The hospital owns and operates the home by employing a management company. Women and their children can live there up to 18 months.
For community outreach, Safe Passage conducts dating violence workshops for teen-agers through community groups. It also communicates information about domestic violence to adult women through the hospital's various educational programs presented by its Women's Health Department. In addition, Safe Passage works with a local mental health center to provide mental health counseling to victims who come through the hospital.
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