Every child, every time: hospital-wide child abuse screening increases awareness and state reporting.

PURPOSE: A review of our child abuse evaluation system demonstrated a lack of standardization leading to low reporting levels. The purpose of this quality improvement initiative was to develop a standard child abuse screening tool; an education program increasing awareness to child abuse; and to measure the impact of the screening tool in reporting. METHODS: A screening tool was developed and implemented for all trauma patients < 15 years of age; staff was educated; and a child protection team (CPT) was established. Within 9 months, screening was extended to all patients admitted to the children's hospital. Screening compliance, number of child abuse reporting forms (CY-47) filed, and consultations to the CPT were monitored. RESULTS: Initially, 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.

Emergency department visits from a local amusement park.

BACKGROUND: There are limited published data examining Emergency Department (ED) presentations associated with amusement parks, and even fewer data on presentations not associated with roller coaster rides. STUDY OBJECTIVES: To determine the spectrum of medical and traumatic presentations to two EDs from nearby amusement parks. METHODS: A retrospective chart review of prospectively identified, enrolled, and surveyed patients was conducted at two EDs in Pennsylvania during the summer of 2006. Any patient presenting with a medical or traumatic complaint that occurred within 12 h of ED presentation and was associated with a visit to the local amusement park was prospectively identified and details of the visit were retrospectively reviewed. RESULTS: There were a total of 325 discharge diagnoses for the 296 ED visits identified; 74% of discharge diagnoses were trauma related. The most common traumatic diagnoses were laceration (27%) and head injury or concussion (14%). The most common non-traumatic diagnosis was heat-related illness (24%). Twenty-nine percent of discharge diagnoses were directly associated with amusement park rides. Eighty-nine percent of patients were discharged home. There were no mortalities reported. CONCLUSION: The majority of ED visits from nearby amusement parks were benign and did not require hospitalization.