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Hospital-Wide Child Abuse Screening Increases Awareness and State Reporting: Results of a Quality Improvement Initiative
Lauren Dudas, MD, Gwenda Petrohoy, MSN, Debra Esernio-Jenssen, MD, Cheryl Lansenderfer, BSN, Joseph Stirparo, MD, Michele Dunstan, MSN, Marybeth Browne, MD

Background: A review of our child abuse evaluation system demonstrated a lack of standardization leading to a reporting level below national averages. The purpose of this quality improvement initiative was to develop a standard child abuse screening tool; establish an education program increasing awareness to child abuse; and to measure the impact of the screening tool in child abuse reporting.

Methods: In January 2014, an objective screening tool was developed and implemented for screening of all trauma patients <15 years of age. Staff was educated with online modules. Education was reinforced during nursing huddles and with continuous case review. In August 2014, a child protection team (CPT) was established including a board-certified child abuse pediatrician. Screening was extended to all patients admitted to the children's hospital in September 2014. Screening compliance and number of child abuse reporting forms (CY-47) filed were monitored between January 2014 to August 2015. Consultations to the CPT were monitored between August 2014 to August 2015.

Results: From January 2014 to August 2014, there was an average screening compliance of 56%. After making the program hospital-wide, the compliance rate increased to an average of 96%, and the average number of CPT consults increased from 2 to 10 per month. Over this study period, the average number of CY-47s filed increased from 6.1 to 7.3 per month.

Conclusions: Hospital-wide use of an objective screening tool, frequent re-education, and the support of an experienced child protection team led to improved child abuse screening compliance and more consistent suspected-abuse reporting rates.

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