Collaboration aims to reduce child abuse

A new collaboration between Ohio Attorney General Mike DeWine and the Ohio Children’s Hospital Association aims to reduce the occurrence of child abuse in infants 6 months and younger by enlisting pediatric practices, according to a news release.

Eight large pediatric practices across Ohio — representing more than 30,000 patients and families and recruited through a partnership with the Ohio Chapter of the American Academy of Pediatrics — will be joining children’s and community hospitals in implementing interventions to identify potential signs of abuse and prevent further abuse in Ohio’s youngest and most vulnerable children.

DeWine funded the Timely Recognition of Abusive Injuries Collaborative with a $1 million grant from settlement funds to OCHA in 2015. The purpose of TRAIN is to prevent repeat child abuse in the most vulnerable population, infants 6 months and younger. The TRAIN Collaborative analyzed what the medical community refers to as “sentinel injuries,” which are minor injuries known to the medical provider that should prompt concern that the child is being abused. Sentinel injuries are often missed by medical providers, placing the infant at risk for further abuse.

The TRAIN Collaborative identified the specific injuries that should be suspect and developed a specific process — or “bundle of care” — that reduces repeat instances of child abuse. If a medical provider discovers a sentinel injury, they use the prescribed “bundle” to assist in the identification of abuse and to ensure the infant receives appropriate follow-up care. The “bundle” includes a skeletal survey of the infant, psychosocial assessment of the caregivers and pediatric consultation.

In 2016, children’s hospitals in Ohio determined that one in 10 Ohio children seen for child abuse has been seen previously with a sentinel injury and fewer than one in three receives the necessary physical examination and follow-up. They worked together to create and test the “bundle” within their own hospitals, and then spread the process to 19 community hospitals across the state. This third phase will teach eight pediatric practices about the “bundle” and help them implement it within their practice.

“We have some of the best minds in pediatric healthcare in the country right here in Ohio. I am proud that we could bring these minds together to identify a proven process to help children who are too young to understand their injuries or even to speak for themselves,” DeWine said in the release. “Spreading this important process to more pediatricians throughout Ohio will mean more children are spared from further abuse — and that has been my goal with this program from Day 1.”

Leaders from TRAIN have been asked to present their findings at national conferences, including the Court Appointed Special Advocate/ Guardian Ad Litem conference.

More information about TRAIN is available at www. ohiochildrenshospitals. org.