A formal organisational change approach was introduced into a mid-sized regional health service, to implement the New Zealand Family Violence Intervention Guidelines and thereby improve detection and quality of assessment of child and partner abuse within the service. More than 700 staff were trained in dual assessment for child and partner abuse. Pre–post evaluations demonstrate improved confidence following training, though staff still need support. Barriers and enablers to asking about partner abuse were identified. Referrals from the health service to the Department of Child, Youth and Family Services increased from 10 per quarter to 70 per quarter. Identification of partner abuse increased from 30 to 80 per 6-month period. Routine questioning rates for partner abuse vary between services.
An important paper for those of us wishing to improve health outcomes through the implementation of best practice guidelines. Although I had some questions about the findings (did improved rates of identification and quality of assessments lead to better outcomes for children and partners?), the study did provide valuable information about ways to improve the way in which a service is delivered. Commitment from all staff in the organisation (including senior managers), collaboration with the community and other stakeholders, sufficient resources/time to support the changed practice and ongoing research, evaluation and training are required.
Independent commentary by Dr. Matire Hardwood
Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.
Research Review publications are intended for New Zealand health professionals.
Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.
