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Child maltreatment detection practices in Israeli pediatric emergency departments: A national study
Ravit Alfandari1, Tal Solomonica1, Tal Frolinger1
1School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Data Analytics for Safeguarding Children Lab, Haifa, Israel.
Insights
Child maltreatment detection in hospital pediatric emergency departments is insufficient, with staff lacking confidence and underutilizing computerized systems. Improved training and mandated computing experience are recommended to enhance practices.
Area of Science:
- Pediatric Emergency Medicine
- Child Protection
- Healthcare Management
Background:
- Child maltreatment underdetection in healthcare settings is a persistent international issue.
- Healthcare systems play a crucial role in child maltreatment prevention and intervention.
Purpose of the Study:
- To investigate child maltreatment detection and management practices in Israeli hospital pediatric emergency departments from the staff perspective.
- To assess the utilization of computerized systems by hospital staff in managing child maltreatment cases.
Main Methods:
- A national survey was conducted with 179 healthcare professionals (physicians, nurses, social workers) across 22 hospitals.
- An online questionnaire was used to gather data on participants' experiences and practices.
Main Results:
- Findings reveal inadequate practices, including underdetection of suspected child maltreatment and low confidence in identifying sexual abuse.
- Staff confidence in detecting abuse and neglect was negatively associated with being a parent.
- Underuse of computerized systems and limited impact of existing training on practice were noted.
Conclusions:
- Current computerized systems offer unsatisfactory support for child maltreatment detection and management.
- Policymakers should consider mandating effective computing experience for healthcare staff to improve practice.
Background:
Healthcare is a prominent governmental sector responsible for addressing and preventing child maltreatment. Yet underdetection of child maltreatment in health systems is a longstanding international concern.
Objective:
This is the first national scale study investigating child maltreatment detection and management practices at hospital pediatric emergency departments in Israel, from the staff point of view. Given the current technological era, particular attention was given to hospital staff experiences using computerized systems.
Participants And Setting:
Participants were 179 healthcare professionals (46 % physicians, 41 % nurses, and 14 % social workers) employed in 22 hospitals around the country.
Methods:
Participants completed an online questionnaire.
Results:
Findings indicate several patterns suggesting inadequate and insufficient practice, including underdetection of suspected child maltreatment cases and low confidence in identifying possible child sexual abuse. Being a parent was significantly and negatively associated with staff confidence in detecting physical abuse (β = -0.17, p = .046), sexual abuse (β = -0.19, p = .030), and neglect (β = -0.19, p = .036). The most common practice reported when faced with cases of suspected child maltreatment was to consult with multiprofessional staff members. Although most participants reported having prior academic or departmental training in child maltreatment, findings suggest training did not play a notable role in practice. A key finding was the underuse of computerized systems in hospitals to support practice.
Conclusions:
Evidence suggests unsatisfactory quality of available computer materials and functions. Policymakers should mandate basic effective computing experience for staff members to improve practice.
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