An evaluation of a system-change training model to improve emergency department response to battered women

Jacquelyn C. Campbell, Jeffrey H. Coben, Elizabeth McLoughlin, Stephen Dearwater, Gregory Nah, Nancy Glass, Debbie Lee, Nancy Durborow

Research output: Contribution to journalArticle


Objectives: To evaluate a system-change model of training from the Family Violence Prevention Fund and the Pennsylvania Coalition Against Domestic Violence for improving the effectiveness of emergency department (ED) response to intimate partner violence (IPV). Methods: An experimental design with outcomes measured at baseline, 9-12, and 18-24 months post-intervention. Twelve hospitals in Pennsylvania and California with 20,000-40,000 annual ED visits were randomly selected and randomly assigned to experimental and control conditions. Emergency department teams (physician, nurse, social worker) from each experimental hospital and a local domestic violence advocate participated in a two-day didactic information and team planning intervention. Results: The experimental hospitals were significantly higher than the control hospitals on a staff knowledge and attitude measure (F = 5.57, p = 0.019), on all components of the "culture of the ED" system-change indicator (F = 5.72, p = 0.04), and in patient satisfaction (F = 15.43, p < 0.001) after the intervention. There was no significant difference in the identification rates of battered women (F = 0.411, p = 0.52) (although the linear comparison was in the expected direction) in the medical records of the experimental and control hospitals. Conclusions: A system-change model of IPV ED training was effective in improving staff attitudes and knowledge about battered women and in protocols and staff training, as well as patient information and satisfaction. However, change in actual clinical practice was more difficult to achieve and may be influenced by institutional policy.

Original languageEnglish (US)
Pages (from-to)131-138
Number of pages8
JournalAcademic Emergency Medicine
Issue number2
StatePublished - Jan 1 2001


  • Battered women
  • Domestic violence
  • Intimate partner violence
  • Model
  • Public health
  • System
  • Training

ASJC Scopus subject areas

  • Emergency Medicine

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