Child abuse is a leading cause of death and disability in children. Each year, Child Protective Services, or CPS, receives more than 3 million reports of child abuse. In addition, nearly 1,600 children die from child abuse each year.
What was the goal of this implementation project?
Often, doctors don’t recognize signs of child abuse and may not screen for it as part of the care they provide. A previous PCORI-funded project found that an alert system built into the EHR can identify children under 13 years old who may have experienced child abuse or neglect. The alert system can also help doctors assess patients, do the right tests, and report to CPS when needed.
The project team expanded the use of the alerts to two health systems in Wisconsin and New York. The health systems had different EHR systems. They also had different ways of providing care to children in the emergency department, or ED. For example, some hospitals had pediatric ED doctors while others did not.
What did this project do?
The project team worked with local information technology, or IT, staff to adapt the alerts for the two EHR systems. Next, the project team trained nearly 1,000 doctors, nurses, and other medical staff in how to use the alert system. The team also worked to improve the system during the project. The team created materials and guidance to help other health systems, with similar EHR systems, put alerts in place in the future.
What was the impact of this project?
The project successfully added the alerts to two EHR systems. After the alerts were put in place, nearly 60,000 children were screened for abuse across both health systems.
Providers in Wisconsin found the alerts helpful, agreed with the guidance the alerts provided, and followed alert recommendations more than 70% of the time. Providers in New York did not find the alerts as helpful and did not agree with the guidance as often. The project team is working to learn about ways to improve the acceptability of the alert system.