Education is not enough: a systems failure in protecting battered women.

A retrospective study of female trauma patients presenting in an emergency department during 1976 and 1977 demonstrated that the introduction of a protocol designed to detect injuries caused by battering increased the identification of battered women from 5.6% of female trauma patients to 30%. An eight-year follow-up study in the same ED demonstrated that only 7.7% of female trauma patients were diagnosed as having injuries secondary to battering. This study suggests that without institutional policies and procedures for detecting and treating victims of domestic violence, many abused women will pass through EDs unidentified and, hence, untreated.