Early identification of non-accidental trauma (NAT) is critical as up to 30% of victims, by some estimates, will be re-injured without adequate protection conferred by early identification. Unfortunately, the identification of NAT is often inconsistent and difficult owing to the sensitive nature of the screening process. This had led to the development of screening protocols by some children’s hospitals to decrease bias and improve NAT detection. Students will work with the clinician and administrative leaders to design a system to improve our screening and reporting of NAT at LPCH.
In 2015, 683,000 children experienced either abuse or neglect in the United States, and 1,670 children died due to either neglect or abuse. Children under 5 account for >80% of all child abuse. With goals to define responsibilities, minimize staff’s emotional and operational burden, minimize parents’ suspicion, and measure capacity to implement a screening program, we identified opportunities for hospital policy changes and are working with LPCH on a pilot screening program. We want to make a system where every patient goes through an automated standardized screening process with minimal and effective nurse screening, a formalized assessment protocol, and a clear chain for next contact and order of escalation.