TY - JOUR PY - 2021// TI - Improved detection of child maltreatment with routine screening in a tertiary care pediatric hospital JO - Journal of pediatrics A1 - Suresh, Srinivasan A1 - Heineman, Emily A1 - Meyer, Lisa A1 - Richichi, Rudolph A1 - Conger, Scott A1 - Young, Shanon A1 - Coombs, Carmen A1 - Berger, Rachel SP - ePub EP - ePub VL - ePub IS - ePub N2 - OBJECTIVES: To evaluate the impact of layering routine child abuse screening on top of a pre-existing electronic health record-embedded child abuse clinical decision support system (CA-CDSS) in a pediatric emergency department. STUDY DESIGN: The Pittsburgh Child Abuse Screening Tool (P-CAST) was performed in all children <13 years of age and in non-verbal children ≥13 years of age who presented to a pediatric tertiary care center over 6 months. The P-CAST was layered on top of a pre-existing CA-CDSS which included passive triggers, alerts and abuse-specific order sets.

RESULTS: Of the 28,797 screens performed, 1.8% were positive in children <13 years old and 1.6% were positive in non-verbal children ≥13 years old. Half of the children with a positive P-CAST also triggered the CA-CDSS; the other half triggered only because of the P-CAST. Nineteen percent of patients with a positive P-CAST were reported to child protective services. There was no relationship between race and the odds of a positive P-CAST, or race and the likelihood of a report being made to child protective services (CPS).

CONCLUSIONS: Active routine child abuse screening improves identification of suspected child maltreatment in a children's hospital above and beyond what is identified with a CA-CDSS which depends on passive triggers. The lack of a relationship between race and a positive P-CAST or a report to CPS suggest that systematic child abuse screening may mitigate well-recognized racial disparities in identifying and reporting of suspected child maltreatment.

Language: en

LA - en SN - 0022-3476 UR - http://dx.doi.org/10.1016/j.jpeds.2021.11.073 ID - ref1 ER -