This project has been designed to improve the response that people who experiencing domestic violence receive when they access services from Lismore Base Hospital. It is multifaceted and includes improving the resources and training available to emergency department staff and developing a discreet domestic violence information resource for clients.
By November 2020 the domestic violence referrals from Lismore Base Hospital emergency department to the Richmond Safety Action Meeting will increase by 50%.
- Reduced stigma attached to domestic violence disclosure.
- Reduced gap in service delivery for domestic violence victims.
- Reduced waiting times for domestic violence victims to receive assessment.
- Increased domestic violence disclosure.
- Discreet support provided to domestic violence victims.
Women are much more likely to be killed by an intimate partner than men. In the four years from mid-2010 to mid-2014, there were 152 intimate partner homicides in Australia that followed an identifiable history of domestic violence. 79.6% were women killed by their intimate male partner, 18.4% were men killed by their intimate female partner and 2% were men killed by their intimate male partner.1
For women between the ages of 18 and 44 years old, intimate partner violence contribute an estimated 5.1% of the burden of disease, which is more than other risk factors for that age group, such as alcohol, smoking or illicit drug use.1
In 2019 the Richmond safety action coordinator had only two referrals of women experiencing life threatening domestic violence from Lismore Base Hospital social workers, despite the fact that 36 women had attended Lismore Base Hospital following an incident of domestic violence that had reached the Safety Action Meeting Health Review.
The project began in March 2020 with initial consultation sessions with Lismore Base Hospital emergency department and social work staff and the domestic violence team from the Richmond and Clarence Valley Violence Abuse and Neglect Service. A three-pronged approach to the problem was developed. Firstly education for emergency department staff and the hospital social workers about the Safety Action Meeting and how it could support victims of domestic violence. Secondly the emergency department staff were provided with improved access to information about support for women suspected of experiencing domestic violence through their intranet portal. Finally a discreet domestic violence resource that could be given to domestic violence clients presenting to the emergency department was developed.
Education sits at the heart of this improvement and, despite the restrictions and limitations imposed by COVID-19, six training sessions for nursing staff and two training sessions for the hospital social workers were held. The sessions explained what the Safety Action Meetings were, how they operated and what they could do to support people who were experiencing serious threat as a result of domestic violence. The training was provided by the Safety Action Meeting coordinator and has now been established as a monthly activity for emergency department nursing staff and a yearly activity for the social work department.
With the support of the local women’s health manager and the health promotions unit, a discreet domestic violence resource was made. This resource can be given to any person who is at risk of domestic violence without concern that it will be identified by the perpetrator of violence and therefore spark further violence. The victim can carry the resource and always have the phone number for the Domestic Violence Hotline with them. This part of the project began its development in March 2020 and was fully funded and ordered by the end of June 2020. The resource started being used in the Lismore Base Hospital in July and over 100 units had been given out to women by November 2020. The resource has proved so popular it is now being handed out to hospitals across the Northern NSW Local Health District from Tweed Heads to Grafton and can be found in seven different sites.
A new violence abuse and neglect tile was added to the emergency department intranet page. This allows staff easy access to resources and information about support services for the victims of domestic violence they are treating. The information was revised and updated in collaboration with the domestic violence hits project officer and the violence abuse and neglect clinical leads. These updates started in September 2020 and were completed by the end of October 2020.
Sustained – The project has been implemented and is sustained in standard business.
- March 2020 – Project starts with the initial meetings of key stakeholders.
- June 2020 – The training sessions with emergency department nurses began and are continuing on an ongoing basis.
- July 2020 - Distribution of the discreet domestic violence resource started.
The project began at the Lismore Base Hospital emergency department, and the discreet domestic violence resource has now spread to Tweed Heads, Grafton, Murwillumbah, Byron Bay, Maclean, Kyogle and Mullumbimby emergency departments.
- Clinical Excellence Commission. Clinical Leadership Program
- Health Promotions Unit
The referrals from Lismore Base Hospital emergency department to the Safety Action Meeting coordinator have increased from 2 to 10 which is an increase of 400%. The initial target was to have an increase of 50%.
103 discreet domestic violence resources were handed out by to vulnerable women, who were identified as being at risk of domestic violence, between July and November 2020.
The success of this project was a result of team work and members of the emergency department championing the cause of domestic violence. By working with the nursing unit manager, the nursing educator and the domestic violence hits project officer we were able to gain support for staff to attend the training, to reinforce the importance of screening women for the risk of domestic violence and promote the Safety Action Meeting as resource to support victims. Without first negotiating the support of these key stakeholders the success of this project may have been limited.
The impact of COVID-19 restrictions also played a part in the success of this project. Health management were aware of the risk that domestic violence may increase as a result of the lockdown and families being forced to remain at home together under stressful circumstance. This meant that they were open to the idea of introducing a new discreet resource for domestic violence victims and the idea was readily embraced and recognised as positive investment into the fight against domestic violence.
- Costello M, Backhouse C. Avoiding the 3 ’M’s: Accurate use of violence, abuse and neglect statistics and research to avoid myths, mistakes and misinformation. Sydney: The NSW Health Education Centre Against Violence (ECAV) Prevention and Response to Violence Abuse and Neglect (PARVAN) Unit, NSW Ministry of Health; 2019.
- Boxall H, Morgan A, Brown R. The prevalence of domestic violence among women during the COVID-19 pandemic. Statistical Bulletin no. 28. Canberra: Australian Institute of Criminology; 2020.
- Campo M, Tayton S. Domestic & family violence in regional, rural and remote communities – an overview of key issues. Child Family Community Australia Practitioner Resource. Melbourne: Australian Institute of Family Studies, Child Family Community Australia; 2015.
- Carson R, Kasplew R, Dunstan J, et.al Identifying and responding to family violence and child safety concerns. Findings from the AIFS evaluation of the 2012 family violence amendments. Family Matters. 2016 Nov; 98:7-15.
Safety Action Meeting Coordinator
Richmond and Clarence Violence Abuse and Neglect Services
Northern NSW Local Health District