Child Death Review Findings: A Road Map for MCH Injury Violence Prevention

1. Child Death Review Findings: A Road Map for MCH Injury &� Violence Prevention�  ������ I�m Chris Miara, Associate Director of the CSN. I want to welcome you to the Children�s Safety Network�s webinar �Child Death Review Findings: A Road Map for MCH Injury and Violence Prevention.� The Children�s Safety Network is funded by the federal Maternal and Child Health Bureau to help MCH agencies and other IVP staff prevent injuries and violence among children and adolescents. �This is one in a series of webinars we have provided this year in response to the Technical assistance requests we receive from MCH and other SHD staff. As always, after the webinar, we strongly encourage you to contact us for additional, one-on-one help. For any questions related to CDR teams, we will collaborate with our sister organization, the NCCDR�also funded by the MCHB�to provide individualized assistance. Contact information will be provided at the end of this presentation. ������ Before we begin today�s presentations, I want to walk through a few logistical issues. First, if you are using Elluminate and experience technical difficulties, please use the direct messaging feature to communicate the problem so that the moderators can help you resolve it. To do this, select �moderator� from the drop down box next to the send button and type your message. You may also use the direct messaging feature to communicate directly with other participants. To do this, select the name of the participant you wish to communicate with from the same drop down box, then type your message. ������ The audio portion of today�s webinar will take place over the phone. However, if you have a microphone on your computer, please make sure it is turned off or muted to prevent feedback. The phone line will be muted while the speakers deliver their presentations. If there is time at the end of the presentations, the line will be unmuted so that participants can ask questions. If there is insufficient time for questions, I (CHRIS HANNA) will be available to answer questions via e-mail or phone after the webinar. ������ Any questions before we get started? Let�s put the phone lines on mute�There will be a few seconds of silence before you hear the speakers. ������ I�m Chris Miara, Associate Director of the CSN. I want to welcome you to the Children�s Safety Network�s webinar �Child Death Review Findings: A Road Map for MCH Injury and Violence Prevention.� The Children�s Safety Network is funded by the federal Maternal and Child Health Bureau to help MCH agencies and other IVP staff prevent injuries and violence among children and adolescents. �This is one in a series of webinars we have provided this year in response to the Technical assistance requests we receive from MCH and other SHD staff. As always, after the webinar, we strongly encourage you to contact us for additional, one-on-one help. For any questions related to CDR teams, we will collaborate with our sister organization, the NCCDR�also funded by the MCHB�to provide individualized assistance. Contact information will be provided at the end of this presentation. ������ Before we begin today�s presentations, I want to walk through a few logistical issues. First, if you are using Elluminate and experience technical difficulties, please use the direct messaging feature to communicate the problem so that the moderators can help you resolve it. To do this, select �moderator� from the drop down box next to the send button and type your message. You may also use the direct messaging feature to communicate directly with other participants. To do this, select the name of the participant you wish to communicate with from the same drop down box, then type your message. ������ The audio portion of today�s webinar will take place over the phone. However, if you have a microphone on your computer, please make sure it is turned off or muted to prevent feedback. The phone line will be muted while the speakers deliver their presentations. If there is time at the end of the presentations, the line will be unmuted so that participants can ask questions. If there is insufficient time for questions, I (CHRIS HANNA) will be available to answer questions via e-mail or phone after the webinar. ������ Any questions before we get started? Let�s put the phone lines on mute�There will be a few seconds of silence before you hear the speakers.

2. CHRIS: Because are the leading cause of death, and a leading cause of hospitalization for children and adolescents, MCH agencies are committed to reducing Injuries and Violence. One of the ways they can do this is by participating in CDR teams. Through their involvement in teams, MCH staff learn about key causes of injuries in their state. They can then assist the team in adopting recommendations likely to address these causes and can play a role in implementing these IP recommendations.CHRIS: Because are the leading cause of death, and a leading cause of hospitalization for children and adolescents, MCH agencies are committed to reducing Injuries and Violence. One of the ways they can do this is by participating in CDR teams. Through their involvement in teams, MCH staff learn about key causes of injuries in their state. They can then assist the team in adopting recommendations likely to address these causes and can play a role in implementing these IP recommendations.

3. Today�s webinar CDR: Injury and violence prevention - Sara Rich, NC CDR Developing action-oriented recommendations - Steve Wirtz , CA DPH Using recommendations to influence change - Jacqueline Johnson, TN MCH - Heidi Hilliard, MPHI Today�s presentation will provide the background and strategies MCH and other IVP professionals can use to become involved with CDR teams as a way of reducing IV among C and A. First, Sara Rich of the NC CDR will give an overview of the role of CDR teams in IVP. Then Steve Wirtz of the CA dept of PH will describe how to write CDR recommendations that are likely to result in the prevention of injuries. Finally we will learn how a local and a state agency used CDR recommendations to influence changes policies and programs. We would like to again thank the MCHB and our speakers today who have generously given of their time today. Today�s presentation will provide the background and strategies MCH and other IVP professionals can use to become involved with CDR teams as a way of reducing IV among C and A. First, Sara Rich of the NC CDR will give an overview of the role of CDR teams in IVP. Then Steve Wirtz of the CA dept of PH will describe how to write CDR recommendations that are likely to result in the prevention of injuries. Finally we will learn how a local and a state agency used CDR recommendations to influence changes policies and programs. We would like to again thank the MCHB and our speakers today who have generously given of their time today.

4. Child Death Review: Avenues to Prevention SARA: Good afternoon. Thank you to CSN for providing this opportunity to explore the role of MCH in CDR as well as CDR�s role in MCH. For those of you who are unfamiliar with CDR, I would like to provide a brief introduction. CDR involves a multidisciplinary team of professionals coming together to share case specific information on the circumstances involved with the death of a child. Each team member shares information from their agency on the child, the family, the community, precipitating events and the death event. The team uses this information to understand the risk factors involved in the death and then identifies strategies to minimize these risks. This area is the focus of our time today-that is, developing recommendations for improving child health and safety based on CDR findings. By working together, MCH and CDR can turn these recommendations into action.SARA: Good afternoon. Thank you to CSN for providing this opportunity to explore the role of MCH in CDR as well as CDR�s role in MCH. For those of you who are unfamiliar with CDR, I would like to provide a brief introduction. CDR involves a multidisciplinary team of professionals coming together to share case specific information on the circumstances involved with the death of a child. Each team member shares information from their agency on the child, the family, the community, precipitating events and the death event. The team uses this information to understand the risk factors involved in the death and then identifies strategies to minimize these risks. This area is the focus of our time today-that is, developing recommendations for improving child health and safety based on CDR findings. By working together, MCH and CDR can turn these recommendations into action.

5. CDR Process SARA CDR began as a local response to better identify child abuse deaths. The early reviews only focused on reviewing abuse deaths in order to improve investigative and judicial systems in the area of child protection. MCHB sponsored a Child Fatality review workgroup of State Title V directors in 1993 to study the growing CDR movement. One of the workgroup�s recommendations was that the overriding goal of any CDR should be the prevention of fatalities and that reviews should be expanded to include all preventable deaths. A number of States took these recommendations to heart and developed exemplary CDR programs based in their Title V programs. These programs expanded the focus of reviews to include not only investigation but improvements in service delivery and prevention. At that point, MCHB received requests from Title V directors for federal guidance and support of CDR. They responded in 2003 by funding the National Center for Child Death Review as a resource for States. MCH involvement spurred additional emphasis in prevention and a need to expand both the mission and players involved in the CDR movement. A key component of this expansion includes taking the findings from the review process, developing recommendations and taking subsequent action resulting in expanding CDR partnerships with MCH, IVP, SIDS/OID programs and community groups. SARA CDR began as a local response to better identify child abuse deaths. The early reviews only focused on reviewing abuse deaths in order to improve investigative and judicial systems in the area of child protection. MCHB sponsored a Child Fatality review workgroup of State Title V directors in 1993 to study the growing CDR movement. One of the workgroup�s recommendations was that the overriding goal of any CDR should be the prevention of fatalities and that reviews should be expanded to include all preventable deaths. A number of States took these recommendations to heart and developed exemplary CDR programs based in their Title V programs. These programs expanded the focus of reviews to include not only investigation but improvements in service delivery and prevention. At that point, MCHB received requests from Title V directors for federal guidance and support of CDR. They responded in 2003 by funding the National Center for Child Death Review as a resource for States. MCH involvement spurred additional emphasis in prevention and a need to expand both the mission and players involved in the CDR movement. A key component of this expansion includes taking the findings from the review process, developing recommendations and taking subsequent action resulting in expanding CDR partnerships with MCH, IVP, SIDS/OID programs and community groups.

6. Healthy People 2010 Objective 15.6: Extend the number of States to 50 and the District of Columbia, where 100% of deaths to children aged 17 years and younger that are due to external causes and 100% of all sudden and unexpected infant deaths are reviewed by a child fatality review team.� Half of states CDR are located in health departments Two out three states have local CDR review teams Nearly all states review deaths under age 18 Half of all states review all causes of death SARA With the encouragement of the HP 2010 objective that all States and the District of Columbia review 100% of deaths to children aged 17 years and younger due to external causes, states are doing well in moving towards a prevention model for review. For 2004, 15 states reported reviewing 90 percent or more of the deaths that are included in this objective. Other components of a prevention oriented review process include: housing the state CDR program in health departments or ensuring that MCH is part of the process. To date, half of the state CDR programs are located in health departments. This is a significant change from just a few years ago when a majority of the programs were housed out of social services. Of those housed in public health, 13 use title V funds for CDR. Two/thirds of the states have local level review teams. This is a key component to a prevention oriented review process because states that have local teams have access to more comprehensive information on the death than a State level review will have. Local reviews mean that local actions can take place to prevent deaths. MCH is a key partner at both the state and local level. The National Center encourages teams to review all preventable deaths of children, to include infants and teenagers. Almost all states review deaths to children under age 18 and about half are looking at deaths due to all causes. While a lot of progress has been made in implementing prevention focused reviews, there is still more to be done. SARA With the encouragement of the HP 2010 objective that all States and the District of Columbia review 100% of deaths to children aged 17 years and younger due to external causes, states are doing well in moving towards a prevention model for review. For 2004, 15 states reported reviewing 90 percent or more of the deaths that are included in this objective. Other components of a prevention oriented review process include: housing the state CDR program in health departments or ensuring that MCH is part of the process. To date, half of the state CDR programs are located in health departments. This is a significant change from just a few years ago when a majority of the programs were housed out of social services. Of those housed in public health, 13 use title V funds for CDR. Two/thirds of the states have local level review teams. This is a key component to a prevention oriented review process because states that have local teams have access to more comprehensive information on the death than a State level review will have. Local reviews mean that local actions can take place to prevent deaths. MCH is a key partner at both the state and local level. The National Center encourages teams to review all preventable deaths of children, to include infants and teenagers. Almost all states review deaths to children under age 18 and about half are looking at deaths due to all causes. While a lot of progress has been made in implementing prevention focused reviews, there is still more to be done.

7. Rubber Meets the Road 80% of states publish an annual report with recommendations Two of three states report recommendations have led to state legislation, policy changes, and/or prevention programs  SARA It is important for CDR teams to continue reviewing as many cases as possible or in some states expand the scope of their reviews. The findings from the case review process are issued in state annual reports and serve as the foundation for recommendations to prevent other deaths. Where the rubber meets the road with CDR is the translation of CDR findings into action. Eighty percent of states issue an annual report with CDR findings and recommendations and two-thirds of the states report that their recommendations have led to new or amended legislation, policy changes and/or prevention programs. We will hear from state CDR coordinators later that will share examples of CDR outcomes from their state. SARA It is important for CDR teams to continue reviewing as many cases as possible or in some states expand the scope of their reviews. The findings from the case review process are issued in state annual reports and serve as the foundation for recommendations to prevent other deaths. Where the rubber meets the road with CDR is the translation of CDR findings into action. Eighty percent of states issue an annual report with CDR findings and recommendations and two-thirds of the states report that their recommendations have led to new or amended legislation, policy changes and/or prevention programs. We will hear from state CDR coordinators later that will share examples of CDR outcomes from their state.

9. Acknowledgements Valodi Foster, MPH, After School Programs Office, California Department of Education Supported in part with grant funds provided through the Centers for Disease Control and Prevention

10. Purpose Focus is on PREVENTION Translating Child Death Review Team (CDRT) findings into ACTION! Partnering with Maternal Child Health (MCH) Developing and writing effective recommendations for action Brief review: California CDRT recommendation study Guidelines for writing effective recommendations Implications for MCH practice

11. Child Death Review Teams (CDRTs) Multi-disciplinary, multi-agency review of circumstances surrounding child deaths Function at state and local levels Serve multiple functions: Identification of causes and circumstances Investigation of CAN & questionable deaths Review community responses and services Surveillance - monitoring and reporting Prevention of future child deaths

12. Role of State and Local MCH CDRT Membership Information sharing Case specific Broader public health perspective Leadership Integrate CDRT processes into MCH activities Using data & findings from CDRT/FIMR Helping to shape recommendations Acting on recommendations Membership: example of recruiting injury professionals- First mtg of injury person to San Diego team - child injuries related to power window accidents Info sharing: pre-death program contacts with families; post death support services Leadership: PH perspective; prevention; policy focus; programs; promotion; champion Integration: data can inform national & state performance measures & local planning; Relationship between FIMR and CDRT; inform recommendations; action Membership: example of recruiting injury professionals- First mtg of injury person to San Diego team - child injuries related to power window accidents Info sharing: pre-death program contacts with families; post death support services Leadership: PH perspective; prevention; policy focus; programs; promotion; champion Integration: data can inform national & state performance measures & local planning; Relationship between FIMR and CDRT; inform recommendations; action

13. CDRT Recommendations Project Questions about the value of CDRTs Variability in the functioning of CDRTs Reviewing cases Collecting data Making recommendations Writing reports Questions about the effectiveness of team recommendations Need for more information Why did we do the CDRT Recommendations project? Quality of team functioning and value-added We did not know about the FIMR evaluation study conducted by the Johns Hopkins University Women�s and Children�s Health Policy Center Bloomberg Sch of PH http://www.jhsph.edu/wchpc/projects/fimrmchjournal.htmlWhy did we do the CDRT Recommendations project? Quality of team functioning and value-added We did not know about the FIMR evaluation study conducted by the Johns Hopkins University Women�s and Children�s Health Policy Center Bloomberg Sch of PH http://www.jhsph.edu/wchpc/projects/fimrmchjournal.html

14. CDRT Recommendations Project Based our study on public health planning model Sampled written reports from 75 CDRTs throughout the United States Developed �Guidelines for Writing Effective Recommendations� Reviewed and assessed over 1,000 recommendations Under looked role of producing recommendations in the planning model Separate documentUnder looked role of producing recommendations in the planning model Separate document

15. The Public Health Approach to Prevention The public health approach is a 4-step process. The public health approach is a 4-step process.

16. Role of Effective Recommendations Recommendations come after Defining the Problem and Identifying Risk and Protective Factors But Before Developing and Testing Interventions They are part of developing solutions

17. Framework for Developing Guidelines for Writing Effective Recommendations Clarifying roles and engaging members in prevention Using data to help define problems Identifying risk and protective factors Developing solutions Proposing strategies, policies, and interventions Monitoring implementation of interventions Promoting accountability through evaluation of impact/outcomes 

18. Writing Effective Recommendations Problem Assessment Written Recommendation Action on Recommendation Developing Guidelines for Writing Effective RecommendationsDeveloping Guidelines for Writing Effective Recommendations

19. Problem Assessment Problem Statement Includes problem definition; local, state & national data; risk and protective factors Best Practices Demonstrates knowledge of �best� or �promising� practices for addressing the problem

20. Problem Assessment (Cont�d) Capacity Demonstrates knowledge of existing local efforts, resources, capacities, �political will�, and/or takes advantage of serendipitous opportunities

21. Written Recommendation Intervention Actor Identifies the persons and organizations (doers) to take action in a manner consistent with the problem assessment Intervention Focus Identifies the recipient (e.g., person, agency, policy, law) of the intended action in a manner consistent with the problem assessment

22. Written Recommendation (Cont�d) Specificity The plan of action described in sufficient detail to allow follow up consistent with: Issues identified in problem assessment Actions appropriate for recipient Places/institutions identified where changes will occur Timeframe for action identified

23. Written Recommendation (Cont�d) Accountability Assigns and obtains buy-in of someone (i.e., team member or other individual) to be accountable for follow up and tracking of progress on actions taken within timeframe identified Spectrum of Prevention Demonstrates awareness of levels of intervention and identifies appropriate level(s) given issues identified in problem assessment

25. MCH Coordinator � Judy Mikesell example for SBS The team doesn�t have to do it all. They can play the important role of being the spark that starts a prevention campaign. In other words, the team's effectiveness in prevention can be simply in knowing where to send its recs for maximum impact. There are a # of places to send recs and the team should be aware of all these options. Maybe there is one person in the community who is a mover and a shaker & who gets things done well. Suppose that your team identifies that Michigan would benefit from legislation requiring that bicycles be sold with bike helmets. If there is a legislator who focuses on traffic safety issues, that legislator may be the ideal person to whom the team�s rec should be sent. In your handouts� A new coalition may instead be needed to address a rec. A prevention activity related to the safety of railroad crossings may be best spearheaded by a new group including reps from the railroads, highway safety professionals and other involved parties. In fact, Amelia here� An existing coalition or group may be a good target for some recs. Recs dealing with the relationship between child welfare services and private service providers may be best referred to a county's existing HSCB. Also in your handouts� These collaboratives often have discretionary funds for this type of activity. Or, your local SAFE KIDS Coalition may be willing to focus their child safety activities based on your review team�s recs. Again, I�ve given you� They do a lot with car seat checks/give-aways and bike rodeos/helmet give-aways, as well as other programs, so don�t hesitate to give them a call if you identify a safety issue that needs to be addressed. Local civic clubs (Lions Clubs, Jaycees, etc.) may be able to move quickest if a team contacts them with their findings regarding a community issue like playground safety or babysitter instruction classes for young people. Or, one agency may be able to take the lead. For example, if the team determines that a particular kind of product has been involved in one or more deaths or serious injuries, that information could be sent to the consumer product safety commissions. Local public health departments may take the lead to implement a targeted infant safe sleep & SIDS risk reduction campaign. Whoever the team works with, be sure the person or group is committed to the idea and has the ability to take action and that you follow up with them to see what they did with your recs. MCH Coordinator � Judy Mikesell example for SBS The team doesn�t have to do it all. They can play the important role of being the spark that starts a prevention campaign. In other words, the team's effectiveness in prevention can be simply in knowing where to send its recs for maximum impact. There are a # of places to send recs and the team should be aware of all these options. Maybe there is one person in the community who is a mover and a shaker & who gets things done well. Suppose that your team identifies that Michigan would benefit from legislation requiring that bicycles be sold with bike helmets. If there is a legislator who focuses on traffic safety issues, that legislator may be the ideal person to whom the team�s rec should be sent. In your handouts� A new coalition may instead be needed to address a rec. A prevention activity related to the safety of railroad crossings may be best spearheaded by a new group including reps from the railroads, highway safety professionals and other involved parties. In fact, Amelia here� An existing coalition or group may be a good target for some recs. Recs dealing with the relationship between child welfare services and private service providers may be best referred to a county's existing HSCB. Also in your handouts� These collaboratives often have discretionary funds for this type of activity. Or, your local SAFE KIDS Coalition may be willing to focus their child safety activities based on your review team�s recs. Again, I�ve given you� They do a lot with car seat checks/give-aways and bike rodeos/helmet give-aways, as well as other programs, so don�t hesitate to give them a call if you identify a safety issue that needs to be addressed. Local civic clubs (Lions Clubs, Jaycees, etc.) may be able to move quickest if a team contacts them with their findings regarding a community issue like playground safety or babysitter instruction classes for young people. Or, one agency may be able to take the lead. For example, if the team determines that a particular kind of product has been involved in one or more deaths or serious injuries, that information could be sent to the consumer product safety commissions. Local public health departments may take the lead to implement a targeted infant safe sleep & SIDS risk reduction campaign. Whoever the team works with, be sure the person or group is committed to the idea and has the ability to take action and that you follow up with them to see what they did with your recs.

26. Action on Recommendation Dissemination specifically states who will receive the recommendation, and includes not only the potential actors and recipients but also appropriate decision makers, funders, and potential supporters.

27. Action on Recommendation (Cont�d) Outcomes/Impacts identifies a mechanism/procedure to document the impacts and outcomes that result from action on team recommendations.

28. Findings from CDRT Recommendations Project Quality of recommendations varied widely CDRTs did best on front end Problem statement Best practices CDRTs scored lowest on follow up activities Written recommendations showed moderate specificity and awareness of Spectrum levels, but lacked clarity on who was to take action

29. Writing Effective Recommendations Practical considerations Small number of cases Recommendations for single cases Knowing what works Involve �experts� (e.g., injury professionals) Best or promising (or even reasonable) practices Local conditions Resources for taking action - capacity How to start on action � e.g., can start small Existing capacity for action Setting priorities Who can take lead (or champion) the action �Political will� for action How to get follow through

30. Qualities of Teams Multi-disciplinary, power in our diversity Potential for a unified voice Politically connected Offer support Provide recognition Make a difference!

31. Lessons Learned Make prevention a priority Value the recommendation process Be realistic � take small steps Identify existing partners & champions Keep track of what you recommend Follow-up Let people know what happens Celebrate successes

32. Keys to Success Guide to Effective Reviews Spectrum of Prevention Writing Effective Recommendations Champions Follow-Up

33. Tennessee Child Fatality Review Program  Child Fatality Review (CFR) Program was established in 1995 and housed out of the Tennessee State Department of Health-Maternal and Child Health 

34. Tennessee Child Fatality Review Program  Publish an annual report with recommendations each year. Publish an annual report with recommendations each year.

35. ATV Background 1982-2001 164 deaths Youth ATV deaths in 2004 (n=7) 5.2% of all vehicle deaths.

37.

38. Jacqueline Johnson Public Health Program Director CFR Program TN Department of Health Maternal and Child Health 5th Floor, Cordell Hull Building 425 5th Avenue North Nashville, TN 37247 Phone: 615-741-0368 Fax: 615-741-1063 Email: Jacqueline.Johnson@state.tn.us It is also important to remember that you�re not alone in this; the community plays as important a role as agency leaders when it comes to prevention. The community whose children will benefit from your prevention initiative must buy into the idea, sharing the vision and supporting the efforts of the team to help keep kids alive. And always remember: if you think somebody else is probably already doing something similar, you�re probably wrong. Teams often describe how their reviews led to the obvious: the first ever, simple but essential community efforts to prevent the deaths of its children. It is also important to remember that you�re not alone in this; the community plays as important a role as agency leaders when it comes to prevention. The community whose children will benefit from your prevention initiative must buy into the idea, sharing the vision and supporting the efforts of the team to help keep kids alive. And always remember: if you think somebody else is probably already doing something similar, you�re probably wrong. Teams often describe how their reviews led to the obvious: the first ever, simple but essential community efforts to prevent the deaths of its children.

39. Michigan Child Death Review

40. Started in 1995 by state MCH director. 83 counties / 74 teams/ 1,200 local team members 25-member State Advisory Committee (who makes up the team?) Average of 833 deaths reviewed each year since all counties were up and running. In 2004, 93% of all external deaths to children were reviewed by local teams. Over 6,400 reviewed since 1995 Also talk about MPHI that runs the program and the funding DHSStarted in 1995 by state MCH director. 83 counties / 74 teams/ 1,200 local team members 25-member State Advisory Committee (who makes up the team?) Average of 833 deaths reviewed each year since all counties were up and running. In 2004, 93% of all external deaths to children were reviewed by local teams. Over 6,400 reviewed since 1995 Also talk about MPHI that runs the program and the funding DHS

41. MVC - Mecosta County Findings from local CDR meetings: 8 deaths involving young drivers in 4 months. Ask teens about their experience in learning to drive, the team was told: Teens don�t always get all 50 hours driving with parent; variety of conditions not required. Parents not completely understanding their responsibilities. Teens/parents not actually required by the State to turn in log book of 50 supervised hours. Approx. population of Mecosta County? 40,000Approx. population of Mecosta County? 40,000

42. MVC - Mecosta County Actions: CDR team organized Teen Driver Task Force, including local teens and officials from three high schools in the county Task Force designed a more detailed log book. Schools agreed to require a parent orientation, and the new log books be completed. Team met with state leaders to ask them to tighten certain requirements/close loop-holes in the GDL.

43. It is also important to remember that you�re not alone in this; the community plays as important a role as agency leaders when it comes to prevention. The community whose children will benefit from your prevention initiative must buy into the idea, sharing the vision and supporting the efforts of the team to help keep kids alive. And always remember: if you think somebody else is probably already doing something similar, you�re probably wrong. Teams often describe how their reviews led to the obvious: the first ever, simple but essential community efforts to prevent the deaths of its children. It is also important to remember that you�re not alone in this; the community plays as important a role as agency leaders when it comes to prevention. The community whose children will benefit from your prevention initiative must buy into the idea, sharing the vision and supporting the efforts of the team to help keep kids alive. And always remember: if you think somebody else is probably already doing something similar, you�re probably wrong. Teams often describe how their reviews led to the obvious: the first ever, simple but essential community efforts to prevent the deaths of its children.

44. At end of entire webinar: CHRIS: The take home messages for today are: if you are a CDR coordinator or team member, and don�t have MCH or IVP professionals on your team, please seek them out. They are excellent resources and can assist CDR in moving ahead to take action. If you are from MCH or IVP, please connect with your local or state CDR team. Ask about their program activities, request copies of their annual reports, discuss ideas for collaboration. Partnerships between CDR, MCH and IVP are mutually beneficial and can help all of us more effectively serve children and families. Effective reviews and recommendations lead to change. At end of entire webinar: CHRIS: The take home messages for today are: if you are a CDR coordinator or team member, and don�t have MCH or IVP professionals on your team, please seek them out. They are excellent resources and can assist CDR in moving ahead to take action. If you are from MCH or IVP, please connect with your local or state CDR team. Ask about their program activities, request copies of their annual reports, discuss ideas for collaboration. Partnerships between CDR, MCH and IVP are mutually beneficial and can help all of us more effectively serve children and families. Effective reviews and recommendations lead to change.

45. Help forge collaboration between MCH and CDR Assist in writing action-oriented IVP recommendations Assist in implementing IVP recommendations www.ChildrensSafetyNetwork.org CHRIS CSN can be a valuable partner in working with your state MCH and CDR agency to implement prevention strategies with specific knowledge of injury topics, policy development, data analysis, library research, and evaluation.One area that CSN can help is identifying national, state, and local resources in partnership with our sister organization the National CDR Center. For those of you not familiar with CSN I would encourage you to visit our website and learn more. CSN can help MCH and CDR work tog and dev recsCHRIS CSN can be a valuable partner in working with your state MCH and CDR agency to implement prevention strategies with specific knowledge of injury topics, policy development, data analysis, library research, and evaluation.One area that CSN can help is identifying national, state, and local resources in partnership with our sister organization the National CDR Center. For those of you not familiar with CSN I would encourage you to visit our website and learn more. CSN can help MCH and CDR work tog and dev recs

46. Building CDR Capacity Training for State and local teams Networking State CDR coordinators Linking to prevention resources and tools Coordinating with other review processes CDR Case Reporting System Sara: The National Center for Child Death Review Policy and Practice helps to standardize practices and build state and local team capacity to prevent deaths. The Center has several resources available to assist teams including the Program Manual for Child Death Review, Guides to Effective Reviews organized by cause of death, the web-based CDR Case Reporting System which is in use in 17 states. We have a website, childdeathreview.org and a listserv which is great for connecting CDR state coordinators around the country. We also maintain a database on state CDR profiles which provides an overview of the status of the programs in the U.S. Another important function of the Center is to link state and local teams with tools to assist them in taking action to prevent deaths and that was the goal of our webcast today.Sara: The National Center for Child Death Review Policy and Practice helps to standardize practices and build state and local team capacity to prevent deaths. The Center has several resources available to assist teams including the Program Manual for Child Death Review, Guides to Effective Reviews organized by cause of death, the web-based CDR Case Reporting System which is in use in 17 states. We have a website, childdeathreview.org and a listserv which is great for connecting CDR state coordinators around the country. We also maintain a database on state CDR profiles which provides an overview of the status of the programs in the U.S. Another important function of the Center is to link state and local teams with tools to assist them in taking action to prevent deaths and that was the goal of our webcast today.

47. Contacts Jacqueline Johnson Tennessee Maternal and Child Health (615) 741-0368 jacqueline.johnson@state.tn.us Heidi Hilliard Michigan Public Health Institute (517) 324-7331 hhilliar@mphi.org Chris Hanna CSN (517) 324-8344 channa@mphi.org Sara Rich National Center for CDR 1-800-656-2434 srich@mphi.org Stephen J. Wirtz, Ph.D. California Department of Public Health (916) 552-9831 Steve.wirtz@cdph.ca.gov Stephen J. Wirtz, Ph.D. Research Scientist, EPIC Branch California Department of Public Health MS 7214 P.O. Box 997377 Sacramento, CA 95899-7377 (916) 552-9831 (916) 552-9810 (Fax) steve.wirtz@cdph.ca.govStephen J. Wirtz, Ph.D. Research Scientist, EPIC Branch California Department of Public Health MS 7214 P.O. Box 997377 Sacramento, CA 95899-7377 (916) 552-9831 (916) 552-9810 (Fax) steve.wirtz@cdph.ca.gov