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Child Maltreatment Data After Implementation of Hospital-Wide Protocol and Sexual Assault Forensic Examiners
Kirsten Morrissey, Kaylin Dawson1, Ashar Ata2
1Division of Forensic Medicine.
Insights
Child maltreatment evaluations are enhanced by sexual assault forensic examiners (SAFE). Implementing a standardized protocol increased case numbers and improved documentation for this vulnerable population.
Area of Science:
- Pediatrics
- Forensic Medicine
- Public Health
Background:
- Child maltreatment presents a significant global health challenge with severe consequences.
- Sexual assault forensic examiners (SAFEs) possess specialized skills applicable to child maltreatment evaluations.
Purpose of the Study:
- To analyze patient demographics and trends following the implementation of a standardized, hospital-wide child maltreatment protocol.
- To assess the integration of forensic examiners into child maltreatment case evaluations.
Main Methods:
- Retrospective review of data from January 2017 to December 2022.
- Inclusion criteria: children under 18 undergoing child maltreatment evaluation at a Level 1 trauma center.
- Focus on evaluations conducted after initiating a standardized screening and protocol involving SAFE forensic evaluations.
Main Results:
- 764 evaluations of 742 patients were completed; 99.9% by trained SAFEs.
- Evaluations were distributed across age groups: 49% in children under 2, 37% in ages 2-10, and 14% in ages 10+.
- A notable increase in case evaluations was observed, from 68 in 2017 to 158 in 2022, peaking at 167 in 2020.
Conclusions:
- SAFE-trained providers are effectively integrated into multidisciplinary child maltreatment evaluations.
- Their involvement enhances education, forensic documentation, and standardization of care for vulnerable children.
- The standardized protocol demonstrates success in managing and documenting child maltreatment cases.
Background:
Child maltreatment is a significant global health concern with significant morbidity and mortality. Sexual assault forensic examiners (SAFEs) provide a valuable skill set and may be utilized in child maltreatment evaluations.
Aim:
The purpose of the study was to describe patient characteristics and trends after implementation of a hospital-wide standardized child maltreatment protocol including forensic examiners in child maltreatment cases.
Methods:
Data from January 2017 through December 2022 were retrospectively collected and reviewed on all children under 18 years old who had a child maltreatment evaluation after initiation of a standardized child maltreatment screening process and protocol incorporating SAFE forensic evaluations at a tertiary care Level 1 trauma center.
Results:
From January 2017 through December 2022, there were 764 child maltreatment evaluations of 742 total patients completed, with 763 (99.9%) evaluations completed by a trained SAFE. There were 378 examinations (49%) completed in children under 2 years old, 281 (37%) in children 2 years old until the 10th birthday, and the remaining 105 (14%) in children 10 years and older. The overall number of cases increased since the initiation of standardized screening and protocol from 68 cases in 2017 to 158 cases in 2022, with peak of 167 cases in 2020.
Conclusion:
SAFE-trained providers can be successfully incorporated in the multidisciplinary evaluation of child maltreatment patients and can add invaluable education, forensic documentation, and standardization of practice in the care of this vulnerable population.
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