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Healthcare IPV Response Project

Strengthening partnerships between DV advocates and healthcare workers

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Case Studies

Case Study:MAHEC
HARK documentation process:The HARK screening is administered on a laminated screening tool, along with 8 other women’s health screening questions. The screener, an MA, LPN or RN, then enters the answers into a designated place in the patient’s chart in the EHR. A positive screen would be left un-finalized in the chart so that the provider would be notified. The nurse is also to verbally alert the provider and obtain Behavioral Health if needed.
Response Process:The responder, whether the provider or BH provider, documents whether the patient, met with a responder, was offered a referral, accepted the referral, made a phone call and/or made a safety plan. There is also a place for the responder to enter a confidential note, separate from the EOB, portal, or clinical summary.
Impact of the work:“I notice that every woman in our office that was positive on [the HARK screener] has got a diagnosis of depression and/or anxiety. Every single one of ’em down the line.  And if their children come to the office, the children have a diagnosis of anxiety and depression… And it’s like it makes sense immediately because you start looking at all these diagnoses and you’re like, ‘Oh, yeah, I’m sure that you have these diagnoses.'” – IPV Screener
Case Study:Alliance Medical Ministry
HARK documentation process:The HARK is given separately and discussed with the provider who elicits the help of the responders. We have created a system in which we can flag our patients as positive active, positive inactive, positive not tracked (for those positives that fall outside of the study parameters [of the last 12 months]), and negative. Providers or medical assistants notify the responder of the positive active HARK, and the responder prepares to respond following the patients’ medical visits.
Response Process:The role of the IPV Responder is to respond to a patient’s “needs because even if somebody is not ready, we’re still communicating access and information and a desire to help them find something that they’re looking for when they get ready to make a decision. And it communicates care and a desire for what’s best for them. And for the folks who get connected [to a DV Agency], you know, those are obviously successful” – IPV Responder
Impact of the work:“There’s a whole bunch of people that have been turned away, left out, discriminated against, and it turns out, we’re here to take care of them, but it also turns out they’ve had all kinds of trauma including domestic violence that, lots of them we didn’t know about it… So it’s been a huge help as far as taking better care of our patients.” – Clinic leadership

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North Carolina Coalition Against Domestic Violence
3710 University Drive
Suite 140
Durham, NC 27707
(919) 956-9124

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