Nonfatal Severe Child Injury Review - the California Model

Nonfatal/severe child injury review will augment the multiagency child death review teams that exist in multiple countries, often tied to child abuse. Some states have added nonfatal child injury review and California awarded a grant to the ICAN National Center for Child Fatality Review (NCFR) to develop guidelines for review of nonfatal severe child injury. The grant ends in 2009 and ICAN-NCFR has begun a new system of hospital based programs that include more than half of the hospital beds for injured children under age five. This probably includes the majority of California's children with family violence related injuries severe enough to require hospitalization. Program models and special issues include: connections between hospitals, review of all injuries at intake, use of ICD9CM codes to detect possible abuse, screening as quality control, personal issues for professionals, multiagency teams and the need for ties with other states, national experts, federal agencies and national associations. The initial model for common data collection includes review of child injuries under age three that were served in a pediatric intensive care unit, PICU. The first data collection included 20 % of possible cases statewide. That should grow to 60% of California, or roughly 5% of the US by the APHA presentation and be augmented by hospitals in other states. The presentation will cover program models, injury codes and data patterns used to detect child abuse, multiagency teams, and prevention programs. Reference will be made to the involvement of public health models and services.