BACKGROUND:

Clinicians are mandated reporters for child abuse and elder abuse. Medical organizations recommend that patients be assessed for domestic violence. To date, the only quality improvement instrument related to family violence is a tool for assessing hospitals' domestic violence efforts. METHODS:

Using the Delphi method of consensus among national experts, we modified the hospital tool (Delphi Instrument for Domestic Violence for Hospital Programs) to make it applicable for primary care offices assessing for family violence (child abuse, intimate partner violence, and elder abuse). Face validity and the ability of an office/nurse manager to complete the tool independently were tested in 32 primary care practices in Ohio and Minnesota. RESULTS:

The final instrument includes 111 items divided into 9 categories with a total possible score of 100%. The highest score among primary care practices was 91.4%, achieved by a family medicine office. Offices that focused on family violence-related issues for more than 4 years and were located in an urban area had higher scores. CONCLUSIONS:

The US Preventive Guideline task force calls for tools related to violence screening and management. To our knowledge, this represents the first family violence quality improvement tool for primary care offices.