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Medical Child Welfare Task Force: A Multidisciplinary Approach to Identifying Medical Child Abuse
Sarah Vega1,2, Shalon M Nienow1,2, Maria Z Huang3,2
1Child Abuse Pediatrics Division.
Insights
Establishing a multidisciplinary task force improved clinician comfort and skills in identifying and managing medical child abuse. This initiative enhanced care for children experiencing this complex form of maltreatment.
Area of Science:
- Pediatrics
- Child Protection
- Medical Ethics
Background:
- Medical child abuse presents diagnostic and intervention challenges for clinicians.
- Systemic failures in identifying and managing medical child abuse can lead to severe patient harm.
- Limited guidance exists for addressing complex medical child abuse cases.
Purpose of the Study:
- To address identified deficits in medical child abuse response within a hospital system.
- To formalize education and multidisciplinary collaboration for medical child abuse.
- To improve the identification and management of medical child abuse.
Main Methods:
- Formation of a multidisciplinary Medical Child Welfare Task Force.
- Implementation of clinician education across various forums.
- Utilization of the electronic medical record for case monitoring and communication.
Main Results:
- The task force fostered institutional leadership support and interdisciplinary collaboration.
- Education and EMR utilization improved case identification and provider communication.
- Post-implementation surveys showed increased provider comfort and skill in managing medical child abuse.
Conclusions:
- A multidisciplinary approach, supported by leadership and integrated technology, is crucial for effective medical child abuse management.
- Formalized education and collaboration enhance healthcare providers' ability to recognize and intervene in medical child abuse cases.
- The Medical Child Welfare Task Force model demonstrates success in improving system response to medical child abuse.
Abstract:
Medical child abuse is a complex form of maltreatment with powerful and long-lasting impacts on the overall health of affected children. The complexity of this condition renders it challenging for clinicians to recognize its presence and intervene appropriately. The failure of medical systems to identify and deescalate care in this form of maltreatment can result in grievous patient harm. Although the medical literature provides limited guidance on how to address these multifaceted cases, several studies advocate for a multidisciplinary approach. Following a severe and chronic case of medical child abuse at our institution, deficits in response became clear within our hospital system. In reaction to these gaps, the Medical Child Welfare Task Force was developed to formalize education and multidisciplinary collaboration around medical child abuse. The support of institutional leadership and the involvement of multiple medical disciplines that commonly encounter these patients was vital to the implementation and long-term success of the endeavor. To facilitate case identification, education was provided to clinicians in a variety of forums. Moreover, we leveraged the electronic medical record to streamline our ability to monitor cases of medical child abuse and communicate the concerns and plan of care to other providers, both within and outside of our health system. A postimplementation survey determined that the establishment of a multidisciplinary team increased provider comfort and skill in identifying and managing cases of suspected medical child abuse.
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