Improve Detection Child Maltreatment at the Emergency Department

Literature shows that when child abuse is approached structurally, the number of detections and reports of child abuse in hospitals increases significantly. The emergency department (ED) functions as the hospital’s front line, and is therefore vital in the detection of CAN cases (Diderich et al., 2013). However, despite this position, EDs do not detect CAN cases as often as they could (Diderich et al., 2013).

The Dutch Health Care Inspectorate has drawn up an assessment framework for hospital policies regarding child abuse. This framework is based on best practices in the Netherlands and is derived from legal and professional obligations. The assessment framework consists of eleven elements that contribute to a structural approach:

1. Board of directors’ policy for dealing with child abuse

2. Hospital policy for dealing with children in EDs where there is a suspicion of child abuse

3. Existence of a child abuse working group

4. Existence of a child abuse special task officer

5. Collaboration with the child protective services

6. Use of child abuse protocols, including detection protocols

7. Promoting skills in detecting child abuse; training programme on child abuse

8. Registration of number of children at EDs where the screening tool is used

9. Registration of the number of children who are suspected of being abused

10. Registration of the number of children where advice is requested from child protective services

11. Registration of notifications/referrals to forms of assistance

Augeo Foundation provides translations of this framework and a questionnaire for organizations who want to improve their policies.