Every child, every time: hospital-wide child abuse screening increases awareness and state reporting



A review of our child abuse evaluation system demonstrated a lack of standardization leading to low reporting levels. The purpose of this quality improvement initiative was to develop a standard child abuse screening tool; an education program increasing awareness to child abuse; and to measure the impact of the screening tool in reporting.


A screening tool was developed and implemented for all trauma patients < 15 years of age; staff was educated; and a child protection team (CPT) was established. Within 9 months, screening was extended to all patients admitted to the children’s hospital. Screening compliance, number of child abuse reporting forms (CY-47) filed, and consultations to the CPT were monitored.


Initially, there was an average screening compliance of 56%. After making the program hospital-wide, the compliance rate increased to an average of 96%; and the average number of CPT consults increased from 2 to 10 per month. Over this study period, the average number of CY-47s filed increased from 6.1 to 7.3 per month.


Hospital-wide use of an objective screening tool, frequent re-education, and the support of an experienced child protection team led to improved child abuse screening compliance and more consistent suspected-abuse reporting rates.

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  1. 1.

    Pennsylvania Department of Human Services. Annual Child Abuse Report (2015) http://www.dhs.pa.gov/cs/groups/webcontent/documents/report/c_208256.pdf. Accessed 5 May 2016

  2. 2.

    Escobar MA Jr, Pflugeisen BM, Duralde Y, Morris CJ, Haferbecker D, Amororso PJ, Lemley H, Pohlson EC (2016) Development of a systematic protocol to identify victims of non-accidental trauma. Pediatr Surg Int 32:377–386

    Article  PubMed  Google Scholar 

  3. 3.

    Louwers EC, Korfage IJ, Affourtit MJ, Ruige M, van den Elzen AP, de Koning JH, Moll HA (2014) Accuracy of a screening instrument to identify potential child abuse in emergency departments. Child Abuse Negl 38:1275–1281

    Article  PubMed  Google Scholar 

  4. 4.

    The Child Protective Services Law (2012) 23 Pa.C.S. § § 6301–6385

  5. 5.

    Louwers EC, Korfage IJ, Affourtit MJ, Scheewe DJ, van de Merwe MH, Vooijs-Moulaert FA, Woltering CM, Jongejan MH, Ruige M, Moll HA (2011) Detection of child abuse in emergency departments: a multicentre study. Arch Dis Child 95:422–425

    Article  Google Scholar 

  6. 6.

    Benger JR, Pearce AV (2002) Simple intervention to improve detection of child abuse in emergency departments. BMJ 324:780–782

    Article  PubMed  PubMed Central  Google Scholar 

  7. 7.

    Hoytema van Konijnenburg EM, Teeuw AH, Sieswerda-Hoogendoorn T, Leenders AG, van der Lee JH (2013) Insufficient evidence for the use of a physical examination to detect maltreatment in children without prior suspicion: a systematic review. Syst Rev 2:109–117

    Article  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Larimer EL, Fallon SC, Westfall J, Frost M, Wesson DE, Naik-Mathuria BJ (2013) The importance of surgeon involvement in the evaluation of non-accidental trauma patients. J Pediatr Surg 48:1357–1362

    Article  PubMed  Google Scholar 

  9. 9.

    Bailhache M, Leroy V, Pillet P, Salmi LR (2013) Is early detection of abused children possible?: a systematic review of the diagnostic accuracy of the identification of abused children. BMC Pediatr 13:202–215

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Marybeth Browne.

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Dudas, L., Petrohoy, G., Esernio-Jenssen, D. et al. Every child, every time: hospital-wide child abuse screening increases awareness and state reporting. Pediatr Surg Int 35, 773–778 (2019). https://doi.org/10.1007/s00383-019-04485-2

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  • Child abuse
  • Universal screening
  • Quality improvement
  • Non-accidental trauma (NAT)