How ERs Are Tackling Domestic Violence Through New Care Models

Emergency rooms see a lot of different cases, but one serious issue stands out. Women who face violence from a partner or family member end up in the ER three times more often than those who don't. Shockingly, 44% of women who are killed by a partner had visited an ER in the two years before their death. This makes ERs a key place to spot and help people in danger.

A new review looked at how hospitals are handling this problem. Researchers searched major medical databases for studies published between 1995 and 2025. Out of over 1,500 papers, only 25 actually studied how ERs put domestic violence support systems into practice. These studies were then grouped using a theory called Normalisation Process Theory, which helps explain how new practices become part of everyday work.

The findings show that most ERs try to cover all parts of care, but it doesn't always go smoothly. Some hospitals have a special worker just for domestic violence cases. Others use new ways of doing things that were created right inside the ER. But staff say the support is often inconsistent. They describe it as "hit or miss" depending on who's working and what's happening that day.

Even so, some things clearly help. When ERs have a clear plan and people feel confident about it, things work better. Listening to patient stories also matters. Staff say hearing real experiences keeps them motivated. Good communication that loops back to the patient makes the whole system stronger.

The review shows that while ERs are trying, there's still a long way to go. Most studies focus on one part of care, not the whole picture. More research is needed to build better, full support systems. Using theories like Normalisation Process Theory can help guide that work.