Center for Injury Research and Prevention

Navigating a Tricky Balance to Address Intimate Partner Violence

November 8, 2017

A note from Joel Fein, MD, MPH, co-director of CHOP’s Violence Prevention Initiative: Today, we are pleased to feature a blog post from Jessica DuBois Palardy, LSW, an Intimate Partner Violence Specialist at CHOP.

Pediatric providers across the country come face to face with the reality of how intimate partner violence (IPV) overlaps with child abuse every day when treating children for injuries sustained during an abusive episode. Because of this overlap, CHOP has partnered with Lutheran Settlement House (LSH) for more than five years to ensure families have access to an on-site counselor equipped with safety planning techniques and resources specific to IPV through the STOP IPV program.

It’s critical to ensure our institutions are maintaining family safety when addressing IPV in a clinical setting. Because our IPV counselors often work with adult caregivers of patients, providers find themselves in the unique position of providing referrals that can’t be documented in a patient’s medical record, which could be accessed by both caregivers, including an abuser. This could unfortunately pose a serious risk for the parent being abused.

With the support of CHOP’s Information Services, nursing and physician leadership, and the legal team, the CHOP IPV Task Force and STOP IPV program created a way for providers to safely refer families. A hyperlink to a referral form is embedded in the patient’s chart in a way that wouldn’t be noticeable to a caregiver. If a provider needs to make a referral to an IPV counselor, the referral form opens in REDCap, a secure tool for online surveys and databases, and the confidential information is accessed in real time by me and other IPV Counselors from LSH.

In this way, CHOP providers are able to safely share the information with the counselors without endangering the family. Because REDCap is accessible and free to any healthcare institution, we are hopeful that in disseminating our methods and successes, other institutions will adopt similar procedures for the safety of their families.

Because of the quick success of the new documentation and referral procedure in the Emergency Department, we plan to disseminate this novel approach throughout the entire CHOP network through our newly developed Intimate Partner Violence Policy and Procedures. We look forward to working with other CHOP units and departments, whether they are inpatient, outpatient, or specialty care clinics, to ensure their documentation methods are safe for the families we care for each day.

As representatives of the CHOP IPV Task Force, Dr. Ashlee Murray and I were proud to present the work CHOP has done to address the tricky balance of addressing IPV in the pediatric healthcare setting at the National Conference on Health and Domestic Violence in San Francisco in September. This biennial conference focuses on the work domestic violence advocates and healthcare providers are doing to increase the safety and stability of families impacted by IPV.  It was very encouraging to see how IPV advocates are forming partnerships with local healthcare settings to address this public health concern through trainings to providers and connections with local resources for families. LSH is proud to be a leader in creating and furthering these partnerships at CHOP and other institutions throughout the Philadelphia area.

CHOP Presenters at Domestic Violence Conference

Jessica DuBois Palardy (left) and Ashlee Murray presenting at
the 2017 National Conference on Health and Domestic Violence.

Click here to watch an interactive webinar from CHOP and Lutheran Settlement House that offers practical strategies for addressing IPV in the pediatric healthcare setting.

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