Safe Discharge Needs Following Emergency Care for Intimate Partner Violence, Sexual Assault, and Sex Trafficking

• Authors: Dabney Evans, Emory University; Matthew Wheatley, Emory University; Michael Clery, Emory University; E Olsen, Emory University School of Medicine; H Marcovitch, Emory University School of Medicine; H Goodall, Emory University School of Medicine; J Gentry, Emory University School of Medicine; N Jackson, Emory University School of Medicine
• Journal Title: Western Journal of Emergency Medicine
• Volume: Volume 24, Number 3
• Publisher: (publisher) | 2023-01-01, Pages 615-621
• Type of Work: Article
• Publisher DOI: http://doi.org/10.5811/westjem.59072
• Keywords: Humans; Patient Discharge; Retrospective Studies; Human Trafficking; Intimate Partner Violence; Emergency Medical Services; Sex Offenses

Abstract

Introduction: For survivors of gender-based violence (GBV) seeking care in hospital emergency departments (ED) the need for medical care and safe discharge is acute. Methods: In this study we evaluated safe discharge needs of GBV survivors following hospital-based care at a public hospital in Atlanta, GA, in 2019 and between April 1, 2020–September 30, 2021, using both retrospective chart review and evaluation of a novel clinical observation protocol for safe discharge planning. Results: Of 245 unique encounters, only 60% of patients experiencing intimate partner violence (IPV) were discharged with a safe plan and only 6% were discharged to shelters. This hospital instituted an ED observation unit (EDOU) to support GBV survivors with safe disposition. Then, through the EDOU protocol, 70.7% were able to achieve safe disposition, with 33% discharged to a family/friend and 31% discharged to a shelter. Conclusion: Safe disposition following experience or disclosure of IPV and GBV in the ED is difficult, and social work staff have limited bandwidth to assist with navigation of accessing community-based resources. Through an average 24.3 hours of an extended ED observation protocol, 70% of patients were able to achieve a safe disposition. The EDOU supportive protocol substantially increased the proportion of the GBV survivors who experienced a safe discharge.