Sunnybrook Health Sciences Centre – Domestic Violence

Introduction

Currently, domestic Violence is reported as one of the public health issues that require the use of both comprehensive and systematic responses from various sectors, one of them being healthcare facilities. An increase in cases of domestic Violence has led to the need to devise a protocol within healthcare facilities with a set of guidelines designed to respond to these cases (Chapter 21). Creating these guidelines is a strategy that aims to improve how different health sectors address these issues, including actions taken by healthcare providers to ensure that the matter is handled with consistency and effectiveness (Chapter 19). Having this protocol is essential in the healthcare setting as it states the necessary steps and procedures needed by health facilities in identifying, treating, and providing support needed by victims of domestic Violence. It goes beyond immediate medical care as it also targets various aspects of patient safety, legal requirements, and the collaborations needed to encourage support services to victims (Chapter 20). The forthcoming Domestic Violence Protocol is a solution that will aim at improving how Community Health Centers respond to domestic violence cases. Having this protocol means applying it to interpreting and applying statutory and case laws relating to investigating domestic violence incidents and responding to them by emphasizing primarily the protection of victims. It will also be helpful when enforcing restraining orders as well as providing enough care and collaboration by supporting these agencies. The ultimate goal will be to create a safe and supportive environment for victims to feel free to seek help and work towards contributing to handling cases of domestic Violence within the community.

Your Domestic Violence Protocol

Presentation Page:

PROJECT NAME: Proactive Response to Domestic Violence (PRDV) Initiative

ORGANIZATION NAME: Sunnybrook Health Sciences Centre

BUSINESS ADDRESS: 2075 Bayview Ave

CITY, ST, ZIP: Toronto, ON M4N 3M5, Canada

TELEPHONE NUMBER: 416-480-6100

FACSIMILE NUMBER: 416-599-4577

WEBSITE ADDRESS: www.sunnybrook.ca

EMAIL ADDRESS: questions@sunnybrook.ca

Definition and Guiding Principles

Domestic Violence is commonly known as a pattern of abusive behaviors that occurs when one partner disagrees with another. It occurs in cases of intimate relationships such as dating, marriage, or cohabitation. It mainly manifests in the form of physical, emotional, and psychological actions that influence how another person behaves (Chapter 19). These behaviors can involve the use of threats or harming one another, and they can take the form of a single act or repeated acts that end up forming a pattern of abusive and controlling behavior.

According to the guiding principles of the PRDV Initiative at Sunnybrook Health Sciences Centre, it is essential to make a commitment to providing safe and effective care to domestic violence victims by adhering to professional and ethical standards.

1. Respect for dignity and autonomy: Every patient has the right to be treated with respect and dignity regardless of their circumstances. This principle acknowledges that patients have the right to make their own decisions on healthcare (Chapter 21).
2. Safety: It is essential to prioritize the safety of victims. When responding to their needs, health facilities should prioritize the patient’s immediate safety. They can do so by providing a safe space and care needed for their well-being (Chapter 20).
3. Confidentiality: Information the victim shares will be kept private and confidential and only disclosed to people with legal consent.
4. Professional and ethical standards: Any action taken should seek to match professional and ethical standards. To enforce these standards, we will need accurate Documentation, proper reporting, and ensuring standard procedures are followed (Chapter 21).
5. Collaboration: Partner with organizations and local agencies to provide a comprehensive response that will be communally accepted in relation to dealing with domestic Violence.
6. Continuous Improvement: It is paramount to review the protocol from time to time, make changes in light of new research, and come up with feedback from time to time (Chapter 19).

Screening

At Sunnybrook Health Science Centre, effective Screening is a vital part of our domestic violence protocol. The screening process can be conducted at various healthcare institutions such as planning clinics, primary care clinics, PHN and social work intakes, mental health clinics, and prenatal clinics (Chapter 21). Our institution’s goal is to screen all women and adolescent girls as they are the most common and vulnerable to domestic Violence. But that does not limit us from screening men and boys who have been victims of domestic violence, as they can also be affected (Chapter 20). Screening is vital despite the reason for the visit, as victims may not voluntarily expose their fears, shame, or naiveness when it comes to domestic Violence. The screening process is conducted in a safe and contained environment to ensure the patient is alone and not in the vicinity of the abuser. Healthcare givers should be well-versed with the right open-ended questions that can help identify their perpetrators.

The questions are to be asked in an empathetic and non-judgmental way that respects the victim’s dignity and autonomy (Chapter 19). Some screening questions that might be asked include, “Do you feel safe around your partner?” or “Has the perpetrator ever threatened to hurt you or hurt you before now?” It is prudent for the caregiver to offer reassurance to the victim about confidentiality and make it clear that any information shared will be kept private unless they choose to share it themselves. Caregivers should also be equipped with the best ways of responding if a patient discloses domestic Violence and offer immediate care and support needed.

Assessment

A detailed evaluation of the victim’s conditions and circumstances is evaluated in the assessment phase of our Domestic Violence Protocol at Sunnybrook Health Sciences Centre to examine the best action to take (Chapter 20). The Assessment will involve a detailed summary of the current complaint and conducting a detailed physical examination. The history should entail a thorough account of the current complaint. That includes the events that led to the visit, the nature and frequency of the Violence, and the profile of the perpetrator. The identity of the perpetrator is asked only if the victim willingly shares such information. Other details include previous instances of Violence, the victim’s present living condition, and the presence of any minors or dependents in the household (Chapter 21). The patient’s full consent is required if a physical examination is to be done, as the examinations might require the victim to disrobe for a proper examination of physical injuries to the body. The caregiver will then examine the patient for any physical injuries or scars and document the findings accordingly. The examination is a sensitive procedure that demands respect for the patient’s privacy and dignity. The assessment phase is critical in determining the immediate course of action to help the victim plan for subsequent interventions. It is also important as it acts as evidence during legal proceedings should the patient deem it fit to involve law enforcement (Chapter 19). The caregivers should have adequate knowledge that can handle such delicate cases in a compassion, non-judgmental manner that reassures the patient’s safety throughout the process.

Intervention

Intervention is a vital process of the PRDV initiative at Sunnybrook Health Sciences Centre. The aim of Intervention will not only address the present physical and emotional needs of the patient but also offer long-term support towards recovery and safety (Chapter 20). There is a need for immediate medical care when a domestic violence case is identified, which will ensure the patient gets a deserving recovery. Emotional support and reassurance will be provided to acknowledge the courage involved in speaking out about the abuse (Chapter 19). The healthcare worker should help the patient plan their safety, such as ways to defend themselves in case of another abuse. It may involve the engagement of a personalized safety plan that provides resources and information about local agencies that deal with domestic violence, counseling, legal services, and shelter (Chapter 21). All the interventions should account for the patient’s autonomy and capacity to make decisions. It is important that the patients feel empowered to make decisions about their care and future plans. That is why a healthcare professional needs proper informed consent to disclose information or make referrals to external agencies. The victims should be informed about their rights and legal options, such as the process of acquiring a restraining order, legal protection for dependents, and the process of reporting the abuse to law enforcement if it gets to that (Chapter 19). A follow-up plan will be established by the healthcare provider to ensure the patient understands each process towards recovery. The plan will be tailored to the patient’s circumstances and needs, which may involve further medical treatment, legal assistance, counseling, and support services (Chapter 20). Trained healthcare professionals should deliver the Intervention as they should be able to demonstrate compassion, empathy, and respect for the patient’s situation. The main aim of the interventions is to promote patient safety and recovery support and empower them to move forwards (Chapter 21). Sunnybrook Health Sciences Centre is committed to providing a coordinated and comprehensive response to domestic Violence. Our strategy towards Intervention addresses the immediate needs and long-term well-being of victims, ensuring they get the needed support and care.

Documentation

Documentation is a vital process of the PRDV initiative at Sunnybrook Health Sciences Centre. The Documentation should be accurate and concise to ensure the provided patient care is qualitative as it serves as critical evidence during legal proceedings (Chapter 19). It is the healthcare worker’s responsibility to complete a legible medical record for the suspected victims of domestic Violence. Some important content of the Documentation include:

1. A historical record of the domestic violence history such as current complaints and injuries, previous experiences of physical and sexual abuse, relevant dates and times, as well as locations of the domestic violence incidents (Chapter 20).
2. Quoting the exact words from the victim where necessary in quotation marks is appropriate. This will render the Documentation more credible.
3. A comprehensive description of the patient’s injuries, such as the color, size, age, type, and location. The injuries should be documented in a body map, which visually represents the extent of the physical harm.
4. The perpetrator’s name, address, and relation with the victim and any children, if applicable, should be documented with the victim’s consent.
5. A description of any medical issues, whether physical or mental, that may relate to the kind of abuse reported (Chapter 21).

When documenting the report, it is prudent to ensure respect for patient confidentiality and compliance with the local and federal laws are followed. The regulations will ensure the documenting process comprehensively responds to domestic abuse.

Mandatory Report of Injury

There are some instances of domestic violence that may necessitate a mandatory report of injury according to local and federal laws (Chapter 19). As staff at Sunnybrook Health Sciences Centre, we implement and adhere to all legal requirements, such as reporting and ensuring that law enforcement is adequately informed of any cases where mandated. Typically, it involves where the injuries involve the use of a weapon, when the victim is a minor, or when the Violence is ongoing or threatening a life (Chapter 20). However, we also ensure that patient confidentiality and autonomy are respected through the reporting process. It is the responsibility of a healthcare worker to effectively inform the patient about their obligation to reporting and the consequences. This ensures that they understand the process and the potential implications.

Continuity of Care

PRDV initiative at Sunnybrook Health Science Centre is dependent on continuity of care. As soon as the immediate needs are addressed, it is our duty to ensure patients get the needed support and tailored care to their individual issues (chapter 21). The process entails regular follow-up visits, referring them to specialized services such as legal aid, and continuing safety planning. As we continue to provide continuity of care, our goal is to empower victims of domestic violence and provide them with the resources and support they need to start over and recover from their incidents. We are dedicated to offering support to our patients throughout the recovery process, ensuring they always have a shoulder to lean on towards their recovery to safety and well-being.

Conclusion

The creation of the Domestic Violence protocol for Sunnybrook Health Sciences Centre has been educative, giving a clear role of a comprehensive, multi-disciplinary method for addressing domestic Violence in a healthcare institution. A clear responsibility relationship has been established through the healthcare administrators and human resource departments’ protocols, which calls for collaboration in policy drafting, training and implementation. The adopted protocol exemplifies the association of theoretical understanding with practical application, stressing on the critical aspect of patient autonomy, confidentiality, safety, and professional ethics.

References

Chapter 19. (n.d). Employment-At-Will- Will and Discharge. Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com.

Chapter 20. (n.d). Employee Rights and Responsibilities. Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com.

Chapter 21. (n.d). Professional Liability Insurance. Jones & Bartlett Learning, LLC, an Ascend Learning Company. www.jblearning.com.