Readiness is the degree to which a community is prepared to take on a SANE program. As you begin the process of program development, there are steps you can take to assure that your institution and community are prepared for SANE services. Several considerations may contribute to successful program development. Determine if there is an existing trauma-informed approach within the health care system (for hospital-based program development) or community (for community-based programs). If not, do some preparatory work with the health care team to educate them on the impact of trauma on the lives of the patients they are serving.
Readiness for SANE programs: Before you proceed with SANE program development, you may find it helpful to network with nurses working in the field. Find other programs in your state/territory or nationally. The International Association of Forensic Nurses is a membership organization of working forensic nurses. You can find a listing of SANE programs on their website.
Find out what is currently happening in your community. Some things to investigate include—
Determine who provides sexual assault services in your community
Local rape crisis advocacy centers
Law enforcement agencies
Prosecution agencies
Health services for sexual assault (clinics, universities, etc.)
Network with these providers to determine support for developing a SANE program
Take time to understand the local statistics on sexual assault
Determine where victims of sexual assault are currently going for medical forensic exam services (Is it far away? Are they not being referred for exams?)
Educate yourself on the local incidents of sexual violence
Begin the process of garnering support within your institution about the need for services (including administrative and clinical staff)
Use the local service providers to assist you in your efforts
Educate yourself on the funding resources that may be available for SANE program development in your state/territory/tribe
Networking and working with those who are currently providing services, near and far, will help you throughout the process
The algorithm below can help individuals or groups that are interested in developing a SANE program within their community. In conjunction with the SANE Program Readiness Assessment tool, the algorithm will help to determine your readiness to proceed and provide guidance on the initial steps. While the algorithm is organized in steps, determining your level of readiness and what steps you need to take to start a SANE program is a fluid process. For example, you may not need to complete each step before starting on the next step. The short-term goal is to make forward progress while improving the current level of care being provided in your community. The long-term goal is the development of a sustainable SANE program that provides quality medical and forensic services to victims of sexual assault and collaborates effectively with community partners.
Step 1 – Is there a need for a SANE program?
How is this determined?
Determine if there is an existing SANE program in your community.
Are there victims of sexual assault who currently lack access to care or who are dissatisfied with the quality of the care available? Are there gaps in services for victims of sexual assault?
Yes – Begin networking with successful SANE programs in your area as well as local and national forensic nursing groups. They will provide essential information regarding their journey toward success and sustainability and will be a source of support throughout the following steps. Proceed to Step 2.
No – STOP. Work toward improving the existing SANE response.
Step 2 – Is there community support for a SANE program?
How is this determined?
Meet with community stakeholders and key partners as described in Section 3.1.
Utilize the SANE Program Readiness Assessment tool.
Determine the resources that currently exist for victims of sexual assault and determine gaps in coverage and areas for improvement.
Yes – Ask community stakeholders and key partners if they are willing to draft letters of support for a SANE program. Begin scheduling regular meetings to discuss the current response to sexual assault with the short-term goal of improving the current response and the long-term goal of developing a SANE program. Proceed to Step 3.
No – Work toward increasing community awareness and the level of awareness among community stakeholders and key partners. Once there is community buy-in and support, proceed to Step 3.
Step 3 – Is there administrative support for a SANE program at a local health care facility?
How is this determined?
Use the information from Steps 1 and 2, as well as the SANE Program Readiness Assessment tool, to develop a brief presentation that highlights the need for a SANE program and the community's support for it. Include information regarding the health care costs of sexual violence as well as the positive impact of SANE programs.
Ask to meet with a representative(s) from the hospital (i.e., hospital administration, medical director, ED director, chief nurse executive, ED nursing supervisor, social services department).
If the administration offers support for a SANE program at their facility, what kind of support can be determined by asking more specific questions, such as:
Is the administration willing to dedicate time and resources to the development and implementation of a SANE program? A SANE program based solely on volunteered time will not be sustainable, and this needs to be addressed before moving forward.
Would the administration support the role of a full-time or part-time SANE program coordinator?
Is there a physician or nurse practitioner who would be interested in fulfilling the role of a medical director for the SANE program?
How would the administration support nurses who are interested in becoming SANEs (e.g., initial and ongoing training needs, compensation for on-call hours and completed exams)?
Yes – Work with administration to learn what the next steps would be for their facility. Simultaneously, proceed with Step 4.
No – Is there another health care facility in the area that might support SANE program development? Is there any indication that continued education and advocacy would lead to administrative support at the current facility? If not, consider developing a community-based clinic or other program model. (Please refer to Section 2.7.) Once support is obtained, proceed to Step 4.
** This step is often the most challenging and may require many discussions, spanning several weeks, months, or years. While this may seem daunting, this step is essential to the future success and sustainability of a SANE program. It is important to remain motivated and determined, and keep in mind the tremendous need for services as well as the support from the community. Seek guidance from other SANE programs as well as local and national forensic nursing groups. **
Step 4 – Are there nurses who are interested in being trained as SANEs?
How is this determined?
Reach out to nurses and other health care providers who might be interested in providing care to victims of sexual assault. Some good places to start are EDs and OB/gyn departments.
Develop a one-page flier to distribute via email, post in break rooms, etc., to generate interest.
Meet with interested nurses, provide additional information, and work with an established SANE program to schedule share time.
Yes – Work toward developing a comprehensive training plan and competency assessment tool. Proceed to Step 5.
No – Provide education to generate and increase interest. You will eventually find the right group of interested professionals. Once you have, proceed to Step 5.
Step 5 – Is there funding available?
How is this determined?
Refer to Chapter 5.
Yes – Develop a strategic plan to achieve your goal of establishing a successful SANE program that will increase access to quality care for victims of sexual assault.
No – Pursue alternate sources of funding as outlined in Chapter 5.