Expanding RI SAFE- Meeting the Needs of Survivors of Sexual Assault Across RI - Rhode Island Hospital, in partnership with statewide healthcare, public health, advocacy, and legal organizations, proposes the Expanding RI SAFE - Meeting the Needs of Victims of Sexual Assault Across Rhode Island to address critical gaps in access to timely, high-quality medical forensic examinations for women and girls who have experienced sexual assault. Despite recent progress through the RI SAFE program, access to trained Sexual Assault Forensic Examiners (SAFEs) and National Best Practice Care remains inconsistent across hospitals, with persistent workforce shortages, geographic disparities, limited consultation capacity, gaps in follow-up linkages, and fragmented data systems. This project directly aligns with the HHS Office on Women’s Health Medical Forensic Access Initiative by implementing a data-driven, systems-level approach to improve access, strengthen workforce capacity, expand ED teleconsultation support during medical forensic care, enhance healthcare system coordination, and improve community connections. The initiative will expand SAFE coverage to additional hospitals, including Women & Infants Hospital and Kent Hospital, moving Rhode Island toward near-universal access to medical forensic care. The project is structured around four integrated strategies: Expanding Access: Deployment of a 24/7 mobile SAFE model and teleconsultation during care to ensure timely, Best Practice forensic care and linkages across participating emergency departments. Workforce Development: Recruitment, training, and retention of SAFEs through standardized education, simulation-based training, and preceptor support to ensure 24/7 statewide coverage and provide medical forensic services to victims of sexual assault and co-occurring intimate partner violence and human trafficking. Data Collection and Reporting: Implementation of a statewide data system to track victim identification, access, workforce capacity, service delivery, and system performance, enabling real-time monitoring and quality improvement. Healthcare Systems Improvement: Standardization of protocols, enhancement of hospital readiness, and strengthening of multidisciplinary coordination across healthcare, advocacy, community agencies, and public health systems. Over 24 months, the project will collaborate with public health and key hospitals to establish a centralized data dashboard, continue to train and retain SAFE-prepared examiners, expand SAFE services to additional hospitals, operationalize SAFE teleconsultation statewide, strengthen community alliances and linkages, and implement continuous quality improvement processes. A comprehensive evaluation framework will measure progress in access, workforce capacity, telehealth utilization, data reporting, and system readiness. Expected outcomes include increased access to medical forensic examinations for victims of sexual assault and co-occurring disorders, reduced geographic disparities, expanded and sustainable forensic workforce capacity, improved timeliness and quality of care, enhanced linkages to community follow-up, and the establishment of a fully operational, statewide, data-driven system for ongoing healthcare system improvement. By leveraging existing infrastructure, strong statewide partnerships, and demonstrated program success, this initiative will create a scalable and sustainable model for improving access to medical forensic care and strengthening healthcare systems for survivors of sexual assault in Rhode Island.
