California statewide hospital network to address child abuse

California is developing a systematic medical approach to evaluate/manage possible child abuse also addressing quality improvement/liability prevention. Children under age three provide the target population with a relatively high rate of severe inflicted injury. Statewide hospital discharge data provides some direction with the initial 67 hospitals chosen by size of population served. A hospital internal data system is added matching medical records with hospital child abuse/neglect reports. The latter, child abuse reports, are problematic for many hospitals with records only on paper in files that are often separate. The ability of the hospital to define and manage these reports is a central issue for this project. A 2009 study with 9 hospitals, collected case and system profiles. Participating hospitals found case management system issues to repair. Hospitals support each other and a few hospitals with computerized child abuse reports provide the current project model for 2010. Other components include 1) a directory of hospital contacts, 2) hospital multidiscipline/multiagency teams, 3) working groups for 10 child burn hospitals and for 32 PICU with 470 beds 4) liaison with local child death review and 5) projected work with child STD and incestuous pregnancy. The project involves over 50% of young injured California children, (about 6% of the US). Smaller hospitals and emergency department outpatient cases will be added. A similar California project with child death review spread to multiple countries. Other states note an interest to join this program. Data and future plans will be discussed.