Victims of human trafficking interact frequently with the healthcare system, and simple screening processes can help providers identify people who are at risk.
Researchers at Allegheny Health Network in southwestern Pennsylvania piloted two screening programs at a Level 2 trauma center in the region that sees about 41,000 emergency patients a year, according to a new study published in the Journal of Emergency Nursing. The hospital previously had no identification programs in place, but after five months in the pilot, 38 patients were identified as potential human trafficking victims.
Just one turned out to be actually trafficked, according to the study, but the pilot identified patients at risk for other trauma.
"Interestingly, we found that not only were formal education and treatment methods effective strategies to improve recognition and save human trafficking victims, but they also increased the identification of other forms of abuse such as domestic violence and sexual assault," said study author Amber Egyud, R.N., chief nursing officer and vice president of patient care services at Allegheny Health Network’s Forbes Hospital and a member of the Emergency Nurses Association, in an announcement.
Screening patients begins at registration, according to the study, where emergency department staff look for social signs of trafficking: a lack of insurance or identification, an offer to pay in cash and being in the company of another person who does all the talking. If these signs were present, the registration desk personnel would fill out the Department of Health and Human Services’ human trafficking tool, which was embedded in the electronic health record.
Potential victims could also use a silent communication tool to alert the care team that they were in an abusive living situation; patients could apply a blue dot to the cup for a urine sample, which would make doctors and nurses aware of the situation.
When a potential victim was identified, clinicians would huddle with social workers and security personnel to determine next steps. Patients were interviewed in a private room about their living situation, and in cases where the patient was under 18, staff would immediately file a report with child protective services.
If adult patients refused any intervention, nurses would follow up 24 hours later with information on shelters and other ways to get help. About 20% of the potential victims in the study accepted rescue from their living situation.
There has been an uptick in human trafficking that coincides with the opioid epidemic. Providers and healthcare organizations are uniquely positioned to help victims if a plan is in place, as victims of human trafficking have more frequent interactions with the healthcare system than law enforcement.
A number of hospitals and health systems are educating clinicians to recognize the signs of trafficking. Doctors should be prepared to accept that many patients may not be willing or ready for help.