A New Quality Improvement Framework to Strengthen DSGBV Identification and Response in EDs and Injury Units
Emergency Departments (EDs) and Injury Units (IUs) are often the first point of contact for people experiencing Domestic, Sexual and Gender-Based Violence (DSGBV). While their immediate role is to treat urgent physical and psychological needs, these settings also offer a crucial opportunity to recognise hidden abuse and link patients with support.
A new Quality Improvement Framework has been developed to help frontline teams respond more confidently and consistently to DSGBV. Informed by national expertise, frontline experiences a national survey and pilot work across Irish sites, it provides practical, tiered guidance using a “Must Do, Should Do, Could Do” approach.
Among 151 respondents from EDs and IUs to a recent survey, including nurses, ANPs, consultants and medical social workers, only 31 reported having a designated DSGBV clinical lead. Fewer than 50 had a written protocol or clear referral pathway and social work support, while integral, was reported as significantly reduced after hours. Training gaps also emerged as a major challenge: 112 respondents cited lack of staff training and only 20 had received training in the last two years. Interest in national or regional DSGBV training initiatives was high however, with many staff keen to engage in structured learning.
Key priorities in the Framework include enhancing staff awareness, establishing local referral pathways, supporting evidence-based screening where feasible and aligning with already available tools and resources. The survey’s themes of limited protocols, inconsistent training, reduced out-of-hours supports and appetite for standardisation reinforce the importance of adopting a consistent, trauma-informed approach.
All EDs and IUs are encouraged to establish local DSGBV referral protocols, provide education and resources to staff, consider screening interventions where supported and track progress through simple quality measures. Developed in partnership with the National Emergency Medicine Programme and informed by pioneering clinical and social work teams across multiple hospitals, this Framework aims to strengthen safety, consistency and support for all patients affected by DSGBV.
The framework is under review by the Chief Clinical Officer Forum and is expected to be launched in Q1 2026.
