@article{ref1,
title="Child abuse and neglect risk assessment: quality improvement in a primary care setting",
journal="Academic pediatrics",
year="2019",
author="Chung, Esther K. and Gubernick, Ruth S. and Lanoue, Marianna and Abatemarco, Diane J.",
volume="19",
number="2",
pages="227-235",
abstract="OBJECTIVES: Practicing Safety™ (PS) is an AAP toolkit to help practices address child abuse and neglect (CAN) risk by increasing screening and providing resources. The objectives, in an urban practice serving low-income children, were to 1) standardize CAN risk assessment and developmental screening and 2) improve resource provision. <br><br>METHODS: A quality improvement (QI) initiative to standardize CAN risk assessment, using materials adapted from PS (aPS) was conducted through the use of &quot;SmartTools&quot; in an electronic health record (EHR). The Edinburgh Postnatal Depression Scale and Parents Evaluation of Developmental Status were used to assess maternal depression and child development, respectively. Charts were reviewed in waves: pre-, immediate post-, and early post-implementation (waves 1-3), monthly for six months (waves 4-9), then quarterly for 12 months (waves 10-13) to assess screening and resource provision for six domains: infant crying, maternal depression, development, discipline, temper tantrums, and toilet training. <br><br>RESULTS: A total of 581 charts were reviewed (waves 1-3: 92, 95, 94, respectively; waves 4-13: 30 each). Screening for infant crying, maternal depression, development, and discipline rose from 0% pre- to over 50% post-implementation. Screening for temper tantrums and toilet training rose from 6% to 72% and 36% to 82%, respectively. For all measures, resource provision improved over time, and all improvements were maintained for 1.5 years post-implementation. <br><br>CONCLUSIONS: Incorporating aPS into an EHR is a practical and effective approach to improving CAN risk assessment and resource provision. This QI initiative is an example of a practice-wide improvement that resulted in clinical practice change.<br><br>Copyright © 2018 Elsevier Ltd. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="1876-2859",
doi="10.1016/j.acap.2018.09.011",
url="http://dx.doi.org/10.1016/j.acap.2018.09.011"
}