Increasing Documentation and Referral for Youth at Risk for Violence Through the Primary Health Care Setting

Abstract

Objective. Evaluate the use of a previsit violence risk screen to determine whether screening during routine care increases health care practitioner’s (HCP’s) documentation of violence risk. Methods. Once consented, adolescents filled out the Violence Injury, Protection and Risk Screen Tool (VIPRS). For usual care screen results were not viewed by the HCP. For the intervention screen results were imbedded in the electronic medical record and viewed by the HCP. The primary outcome—documented reference to violence risk—was determined by chart review. Results. Three hundred and fifty-six youth participated. Age was 14.5 years (SD 0.3); 65% female, 45% Hispanic, 38% black. Odds of violence related documentation was 47.4 (P < .001) in the intervention compared with usual care. Those who were positive on the VIPRS had a 10 times greater odds of receiving a violence intervention compared with controls. Conclusions. Previsit screening for violence risk significantly increases HCP’s documentation of violent behavior and referral for intervention.