1. Initial response to Family Violence – Alfred Health
Bridget Wall
Manager – Acute Social Work , Aboriginal Health & Pastoral Care
The Alfred
Cathie Smith
Allied Health in Emergency Department Team Leader

2. Alfred Health Family Violence
Background
Ongoing Professional Development for Social Workers
Development of Social Work Priority Tool
Family Violence/Assault/Elder Abuse/Sexual Assault
For a number of years the social work service at The Alfred has undertaken professional development in a range of areas, including family violence. This education has taken many forms from guest speakers from family violence agencies through to case presentations. In 2011, due to an increase in social work demand, we developed a priority tool. Priority 1 work for social work is that which we consider a response and assessment must be completed within 4 hours of referral – ie the most urgent referrals. Family violence, sexual assault and elder abuse are priority 1 referrals for us. So what that means is that if the dedicated unit worker is not available, this referral is allocated across the department for urgent action. So this is where education and training in family violence is crucial for all of my staff, not just those working in trauma and ED. It is also crucial for staff working after hours and on weekends.

3. Alfred Health Family Violence
In 2015 Alfred Health Forum
In 2015, the social work service approached Australian of the Year Rosie Batty to work with us on developing an organisational wide guideline and to provide us with her story and recommendations for large public health services such as ours. What started out as a small professional development session turned into the largest attended forum in Alfred Health history – packed capacity at every venue and streamed via video link to every satellite service. In terms of raising awareness of this issue we certainly met that target – there were many aspects of Rosie’s presentation that stood out for us but this brief audio reached out to all staff to take some responsibility for assisting when and where they can….Rosie goes on to highlight the importance of staff feeling supported and knowledgeable about what they can do assist when disclosures does occur. Rosie also stressed that family violence is more than just patient care but our community as well in terms of a hospital being responsible for its staff as well as consumers.

4. Alfred Health Family Violence
Governance was required in the form of an organisational wide policy and guideline
Hospital wide feedback sort – including consumers in these guidelines
Ante natal screening at Sandringham Hospital – happening already (Women’s Health Service)
Alfred Health establishing an executive sponsored working group to oversee education and governance of the policy and guideline
So we were keen to capitalise on this momentum. I seconded one of my senior social workers to work on developing a hospital wide policy and guideline. One of the issues that Rosie spoke so passionately about was the need for all hospital staff to be aware – not necessary know how to intervene but to be aware of what they can do in terms of support and referrals. She gave the example of attending a busy ED, not feeling 100% comfortable to disclose, but perhaps late night whilst making a cup of tea on a ward, a woman might get into conversation with a nurse, cleaner etc so it was crucial allo staff (and for us that’s 12000) to know how to respond.

5. Challenges from an ED perspective
Responsibility of getting it right – the first time upon presentation in the context of a traumatic injury
Pressure of time in ED whilst engaging with client in a meaningful way
Challenges of an adult environment > including after hours response, reading past presentations to ED, coding currently not reflecting actual presentations
Challenge of coordination of services on discharge (eg) D&A, mental health and FV support workers
Shift in service response