Health Care Can Change from Within: A New Model to Improve the Prevention and Treatment of Intimate Partner Violence

1. Health Care Can Change from Within: A New Model to Improve the Prevention and Treatment of Intimate Partner Violence L. Kevin Hamberger, Bruce Ambuel, PhD, PhD, Marlene Melzer, MD, Mary Beth Phelan, MD & Amy Kistner, MS, Clare Guse, MS Medical College of Wisconsin

2. Overview The Healthcare Can Change from Within Model Changing Clinic Systems: Results Helping Battered Women: Early Results

3. Healthcare Can Change From Within Academic-Community Partnership Funded by a grant from the Healthier Wisconsin Partnership Program

4. IPV is a health care issue

5. Models of change Key leaders (surgeon general) Professional associations Regulatory: JCAHCO Mandatory CME Education -- the black box model Collaboration with community advocates Policies and procedures

6. Failure to bring about sustained change Lessons from McCleer & Anwar and associates

7. Healthcare Can Change From Within

8. What Multi-dimensional Training & education Systems change Policies and procedures Protocols Chart prompts Patient environmental changes Collaborative Multidisciplinary

9. � Harness internal expertise to change and sustain healthcare culture that values and responds to IPV as a health issue Emphasizes IPV as a health care problem Public health issue-primary prevention Medical problem w/ health consequences: intervention/secondary prevention Cost effective

10. Key Features: Total system change Develop on-site healthcare advocates Saturation training of all staff�everyone has a role Policies and procedures for screening, documentation, intervention and prevention Creating a trauma sensitive environment

11. Health care advocate training In depth 20 hours Modeled on DV advocacy training Health care systems change added Time commitment 4 hours per week during intensive staff in-services 1-2 hours per week after training

12. Health Care Can Change from Within: Change in Health Care Systems Bruce Ambuel, PhD, L. Kevin Hamberger, PhD, Clare Guse, MS, Amy Kistner, MS, Marlene Melzer, MD & Mary Beth Phelan, MD Medical College of Wisconsin

13. Research Design: Clinic Change