Multidisciplinary Quality Improvement Approach to Standardize Care and Communication for Suspected Child Abuse Arriving to the ED

Processes of Multiprofessional Child Protection Decision Making in Hospital Settings: Systematic Narrative Review

“…However, only about a quarter ( n = 6 studies) of the studies in this review actually approached professionals and collected information directly from them. The methodologies used in these studies explored professionals’ working-together experience, including data gathering using a questionnaire, Delphi approach, a task-tracing instrument, and rapid improvement events (Balsley et al, 2019; Kistin et al, 2010; Okato et al, 2018; Ross et al, 2019) as well as two studies that used semistructured interviews (Itzaky & Zanbar, 2014; Svärd, 2014). These studies emphasized the importance of professionals’ feedback on their everyday practice and its crucial contribution to meeting key goals such as: identifying weak links in the workflow: For example, indicate on communication gaps in the habitual way the work is carried out (Balsley et al, 2019); uncovering insufficient expertise: -For example, competence and skills around particular patient populations, such as pregnant women (Okato et al, 2018) or patients with reported sexual abuse (Hoehn et al, 2018); direct improvement efforts to meet workforce needs: For example, when professionals voiced the importance of encouraging active interprofessional collaboration and team collegiality, as well as investment of hospital’s resource (Kistin et al, 2010); and detecting unexpected and unwanted outcomes of reforms: -Such as limited investment of time by in-hospital social workers in CPTs CM activities (Ross et al, 2019) following the introduction of a care coordination strategy leading, escalation in power struggles and friction between social workers and physicians following an increase in physicians’ confidence dealing with SCAN following training (Itzaky & Zanbar, 2014), and the impact of institutionalized norms of action (e.g., juridical, therapeutic, or medical) on the role or position (i.e., active, passive, or reflective) social workers took in CPTs (Svärd, 2014).…”

“… Communication facilitators: Implementation of artifacts to enhance easy and useful communication with the team and among team members. For example, internet-based internal reporting system of SCAN cases to the team (Teeuw et al, 2017), structured communication tools, and standard scripts (Balsley et al, 2019). Availability of external consultation: Opportunities and networks for consulting with professionals in the community, including child welfare and protection services.…”

“… In-hospital training on multiprofessional working: Training programs for staff, for example, physicians (Itzhaky & Zanbar, 2014) or ED personal (Goyal et al, 2013) around CM and related local working procedures. Regular performance review: Measures taken to review and evaluate the quality of teams’ performance. For example, implementation of self-evaluation tool (Kistin et al, 2011), continuously review of all cases by a pediatric child abuse specialist (Goyal et al, 2013), and collecting feedback from patients’ families (Balsley et al, 2019). …”

“…Communication facilitators: Implementation of artifacts to enhance easy and useful communication with the team and among team members. For example, internet-based internal reporting system of SCAN cases to the team (Teeuw et al, 2017), structured communication tools, and standard scripts (Balsley et al, 2019).…”

“…Regular performance review: Measures taken to review and evaluate the quality of teams’ performance. For example, implementation of self-evaluation tool (Kistin et al, 2011), continuously review of all cases by a pediatric child abuse specialist (Goyal et al, 2013), and collecting feedback from patients’ families (Balsley et al, 2019).…”