P0231 - Performing High Quality reports of suspected child maltreatment by using an innovative toolkit

Background and objective: Child maltreatment is a major cause of direct and indirect injuries, trauma and latent health problems associated with adverse childhood experiences, such as obesity, health risk behaviors, and mental health problems. Lack of recognition and reporting of suspected maltreatment may leave children vulnerable to continued victimization that can lead to devastating consequences for children and their families. As per Wisconsin law, medical providers and social workers are among those professionals mandated to report to Child Protective Services (CPS) when child abuse is suspected. Issues arise from the starting point of making the decision to report all the way to the communication of pertinent information to CPS. A better understanding of these barriers represents an opportunity for improvement and system change with the ultimate purpose of improving children safety. We aim to improve the mandated reporting process via use of the Safety Advocates for Endangered children toolkit (SAFE children) so that 95% of medical providers in Children’s Wisconsin (CW) urgent care centers will report high confidence on making high quality reports of suspected child maltreatment and at least 95% will report an increase in efficiency when reporting.

Methods: Our QI team outlined our theory for improvement, and multiple plan-do-study-act cycles will be conducted to test interventions aimed at key drivers. Interventions include the use of the SAFE children toolkit, targeted medical provider education, and integration of an electronic mandated reporting check list into the electronic medical record system (EMR) to facilitate high quality mandated reporting. Our primary outcome is the increase in percentage of medical providers reporting improved confidence and efficiency in performing high quality reports.

Results: We will apply structured surveys to gather data on improvement while testing the use of the SAFE children toolkit. We will also perform data analysis on consistency in high quality reporting via the implemented electronic checklist.

Conclusions: Using improvement methodology, we hope to successfully facilitate and standardize performance of high-quality reports in urgent care centers. Targeted education, the use of a mandated reporting toolkit and EMR check list will be associated with improvement in confidence and efficiency when performing high quality suspected child maltreatment reports.