Routine intimate partner violence screening for adult women in primary care: a quality improvement initiative

Abstract

Background: Intimate partner violence is a prevalent public health problem associated with significant short- and long-term health consequences for women and their families. National organizations recommend routine intimate partner violence screening for women; however, screening remains inconsistently implemented in primary care. Local Problem: At a large primary care clinic in Montana, annual wellness visits lacked standardized intimate partner violence screening, resulting in missed opportunities for identification and early intervention. Methods: The quality improvement project used the Institute for Healthcare Improvement Model for Improvement and iterative Plan-Do-Study-Act cycles. Manual chart reviews were conducted over six weeks to evaluate screening completion, documentation consistency, identification of intimate partner violence, referral practices, and staff satisfaction. Interventions: Key interventions included staff education, implementation of a standardized workflow for intimate partner violence screening during annual wellness visits, use of a modified screening tool, standardized documentation via an Epic SmartPhrase, and a visual reminder tool to support staff adherence. Results: Of 37 eligible annual wellness visits, 87% included intimate partner violence screening, exceeding the project goal. Standardized documentation was used in 100% of screened visits. One intimate partner violence disclosure and one child abuse concern were identified, with appropriate referrals offered and accepted. Staff satisfaction with the workflow was high. Conclusion: Routine, workflow-integrated intimate partner violence screening during annual wellness visits is feasible, acceptable, and effective in improving screening consistency and facilitating disclosure. This project supports standardized, trauma-informed intimate partner violence screening as a practical strategy to enhance secondary prevention and patient safety in primary care.