Emergency Department Implementation of Care Models for Individuals Experiencing Family and Domestic Violence and Abuse: A Systematic Scoping Review.

Family and domestic violence and abuse (FDVA) is a major public health issue. Emergency Departments (EDs) are critical points of contact: women affected by intimate partner violence attend EDs at triple the rate of unaffected women, and 44% of women killed by a partner presented to an ED in the 2 years prior. Normalisation of comprehensive responses is important to sustain effective care. This scoping review synthesises research regarding implementation of FDVA care models within ED, guided by Normalisation Process Theory (NPT). Systematic searches of Medline, Embase, CINAHL and Scopus identified relevant peer-reviewed publications from 1995 to 2025. Two independent reviewers screened 1,529 records; 25 met inclusion criteria (reporting implementation of FDVA models of care in ED). Extracted data were mapped to NPT to identify common themes. Eleven studies described implementation and at least two components of comprehensive care, and seven addressed all components (referral in, context of care, care delivered - the most common, referral out). Mapping to NPT revealed key themes: Coherence, driven by a 'Dedicated FDVA Practitioner' and the 'Novel Care Model'; Cognitive Participation, described as 'Hit and Miss'; Collective Action, featuring models 'Born of the ED' and 'Confidence'; Reflexive Monitoring - highlighting 'Individual Stories' and 'Closed-loop' communication as key motivators. This scoping review identified key commonalities in the current literature that support normalisation of comprehensive FDVA care within EDs. Further research is needed that explicitly addresses both comprehensive care models and their implementation. NPT is a valuable framework for research on implementing FDVA models of care.