All programs should provide the patient with options for followup care after discharge. This may be done with the program itself or with community partner organizations, such as health departments, community health clinics, university health services, or Planned Parenthood. These community services should have been identified during the assessment phases of program implementation.
Options for Follow Up
The SANE program may provide the follow up, but if the program is not able to provide that care, there are other options. Keep in mind that some options may not be comfortable for male patients.
Primary care providers
Local public health department
Local women’s clinic
Planned Parenthood
Community clinics
Other community health or STI clinics
Child abuse pediatric programs
Children’s Advocacy Centers
Danger/Lethality Assessment
For patients who are being seen after an assault by an intimate partner, it is important to discuss with the patient signs of increased danger or risk for death. Many programs may use formalized lethality or danger assessment tools.
Safety Planning
All patients should be assessed for safety at discharge. This should include a determination of whether they have a safe place to go. Depending on where they were assaulted, and who the assailant was, the patient may need help in determining where they can go at discharge. This may necessitate the involvement of other community agencies to assist the patient with transportation, housing, and other needs.
Patient Resources and Discharge Instructions
Written discharge instructions should be a component of any discharge from the facility. Recognize that patients in the aftermath of trauma will not be able to recall all the information provided during the visit. It is essential that written discharge instructions include—
Treatment delivered
Medications administered at the time of the examination
Any necessary followup appointments and medications for patient initiating HIV prophylaxis
Phone numbers for the program
Names and numbers for other recommended followup services (counseling, housing, legal)
Law enforcement case number and investigating agency, if appropriate
How to report if a patient has originally chosen not to cooperate with a law enforcement investigation
Other Considerations at Discharge
Patients may choose to return to an abusive partner or living situation. It is essential that programs consider the ways that patients are contacted by the facility. Some patients may need specialized referrals to mental health services or additional health care providers. For example, a patient found to be HIV+ at the time of the exam should be referred to an HIV provider.