Optimizing Care Pathways for Victims of Violence Against Women in Emergency Departments Through Multi-Criteria Decision-Making  
Author

Costanza Laura Parlapiano

 
Co-Author(s)

Silvia Carpitella;  Antonella Certa; Alice Ilardo; Cinzia Muriana; Maria A.L. Zambito

 
Abstract Emergency Departments (EDs) represent the first point of contact for victims of gender-based violence. Not only does the effective management of such cases depend on clinical assessment, but it also relies on key factors that trigger processes. Conventional triage systems primarily consider clinical severity, often overlooking psychological and social risk factors, thereby generating inefficiencies within the care pathway. To address this gap, this study proposes a decision-support framework aimed at including psychological information to enhance the ED management efficiency, specifically within the italian “Codice Rosa” protocol. The model integrates the Analytic Hierarchy Process (AHP) and the Technique for Order Preference by
Similarity to Ideal Solution (TOPSIS) methods to support management prioritization in gender-based violence cases. First, the care pathway was mapped and data from 638 ED cases (from 2022 to 2024) were analyzed. Then, AHP method was applied to weight clinical, context-related, and patient-reported criteria,
while TOPSIS generated relative closeness scores to classify patients into risk clusters. Finally, a sensitivity analysis confirmed the robustness of the framework, highlighting the importance of psychosocial factors, particularly in lower-urgency cases. The results show that integrating clinical, context-related, and psychological information allows the identification of highrisk situations that might otherwise remain undetected, supporting more timely and targeted interventions.

 
Keywords process management, risk management, multi-criteria decision making, violence against women
   
    Article #:  RQD2026-222
 

Proceedings of 31st ISSAT International Conference on Reliability & Quality in Design
August 5-7, 2026