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Intimate partner violence is a lead cause of ill health and premature death among Australian women. Abused women are likely to present to Emergency Departments. Routine screening provides opportunities to identify and respond to intimate partner violence. A six-month screening feasibility study was conducted in two rural and one urban NSW Emergency Departments. Surveys with participating nurses, medical officers and social workers, as well as focus groups with nurses and social workers were conducted at each site to understand their experience. Survey respondents (n = 198) agreed it was appropriate (87%) and acceptable (91%) to screen for intimate partner violence in Emergency Departments. Overall 62% of respondents suggested screening had positive impacts on womens' care. Focus group discussions with 39 nurses and social workers identified enablers of screening as: ease of use of the screening tool; availability of social work response within one hour (as per the study protocol); and executive support. Barriers were: high patient volume; lack of integration with existing processes; lack of privacy and brevity of training. Screening in Emergency Departments was strongly supported by health practitioners who responded to the survey. Work is needed to address competing demands, integration of screening processes, and staff training. [ABSTRACT FROM AUTHOR]

Objective: To test feasibility of a systematic approach to routine screening and response for intimate partner violence among women presenting to three New South Wales EDs. Methods: This prospective feasibility study was conducted over 6 months in two rural and one major tertiary metropolitan ED in New South Wales. Women aged 16–45 years triaged category 3–5 (treat within 30 min/1 h/2 h), who could be approached privately, were screened for intimate partner violence using the validated HITS (Hurts, Insults, Threatens and Screams or Swears) tool. The follow‐up protocol for patients who disclosed abuse, specified a social work/psychology (psychosocial) response within 1 h. Outcomes of interest were screening rates of eligible presentations, disclosures of abuse, psycho‐social referral and responses. Interviews conducted with ED medical directors and nurse unit managers at each site explored barriers and facilitators. Results: A total of 1047 women (11.4% of eligible presentations) completed screening at their first or subsequent presentation. Of 868 women screened on first presentation, 18% (n = 154) disclosed intimate partner violence, with no significant differences by age group, country of birth, triage category or time/day of arrival. Key barriers to screening were high patient volume, absence of electronic prompts and lack of privacy. Of those who screened positive 49% (n = 75) received an immediate, on‐site psycho‐social response. Conclusion: The present study demonstrates that it is both possible and relevant, given the 18% disclosure rate, to screen women in relation intimate partner violence in EDs and provide a psycho‐social response within 1 h. More needs to be done to address barriers to screening to provide opportunities for early intervention. [ABSTRACT FROM AUTHOR]

Background: Healthcare organisations are increasingly adapting their delivery system models to focus on total populations and move away from volume-driven, fee-for-service models. One key example of this change internationally is with the establishment of Accountable Care Organizations (ACOs) where provider groups are held accountable for the total costs and quality of care for a defined population. In this workshop we will offer an academic, policy and service provider perspective on the applicability of ACO models of care for Australia. Aims and objectives: The objective of the workshop is to critically appraise international ACO models and to understand the cultural, policy and implementation considerations that need to be considered if such models are to be considered in Australia. Format: The workshop will be delivered in four parts. Part 1: The findings from an evidence synthesis of accountable care models will be presented. We will highlight what is known about the structures, capabilities and outcomes of these models and highlight exemplar models that are most relevant to the Australian health system. Part 2: The Australian and NSW policy environment will be reviewed. Several initiatives at both federal and state levels are currently underway with the aim of moving the health system toward population-based care delivery models. These will be reviewed and their relevance to ACOs will be discussed. Part 3: The implementation considerations of population-based health care delivery models will be discussed from a service provider perspective. The North Coast Primary Health Network and the the Northern New South Wales Local Health District are implementing several projects exploring locally driven strategies to address care fragmentation. Examples include projects to enhance consumer health literacy and self-management, support for patients at high risk of hospitalisation during winter and the 'reverse ambulance' program. Such strategies feature strong consumer and community engagement using co-design principles, pooled funding and commissioning of services, and establishing critical infrastructure to enhance sustainability. Part 4: In the final part we will engage workshop participants to: (1) critically appraise the information presented; (2) identify the models and model components of ACOs that are most relevant to Australia; (3) understand what policy reforms are needed to enable these models; and (4) identify potential risks and unintended consequences of their implementation. Target audience: We encourage a diverse audience of consumers, service providers (from primary through to tertiary care), managers, and funders to bring their unique perspectives to this workshop. Learnings: Health systems around the world are exploring innovative funding and care delivery models to improve health and performance outcomes. This workshop will make an important contribution to the dialogue on health system reform in Australia. [ABSTRACT FROM AUTHOR]