1827

1. 2008 1827

2. Reporting Domestic Violence: An Electronic Streamlined Approach LCDR Christina Jamieson, NC, USN Division Officer, Inpatient Pediatric Unit Pediatric Nurse Practitioner

3. Child Abuse Prevention Team “Valuing, Protecting and Advocating for our Military Families” • Team established in January 2007 in response to Deputy concerns about internal and external communications and procedures regarding child abuse or neglect.

4. CAPT Mission • To actively improve all systems that serve persons involved in child maltreatment as well as improving collaboration and coordination between departments, providers, and agencies involved. • Improve training and education within command and outlying medical clinics to increase likelihood of early intervention thus decreasing actual cases of child abuse.

5. CAPT • A multidisciplinary team of health professionals addressing: • Child abuse prevention • Education and training • Liaison and enhanced relationships with civilian and DOD agencies • Review and revise command policies and SOPs pertaining to child abuse • Sub-Committee of the Perinatal Advisory Board (PAB)

6. CAPT • Pager Duty • Liaison • Reporting Information • Plan of the Day

7. CAPT • Departmental Training • Teaming with the FFSC’s Domestic Violence Prevention Services • Residents • Monthly, every third Friday • Patient/Staff Education

8. The new voice-mail system at a local mental hospital - If you are obsessive, press 1, repeatedly.- If you are co-dependant, ask someone to press 2 for you.- If you have a multiple personality disorder, press 3, 4, 5 & 6.- If you're schizophrenic, listen closely and a little voice will tell you which number to press.- If you are paranoid, stay on the line. We are tracing your call.

9. CAPT • What is wrong with the current reporting system?

10. Statistics • Significance of Child Abuse in the United States-2005 • Total “reported” incidents: 1,915,641 • Total Rate/1000: 26.2 • Substantiated Incidents: 899,454 • Substantiated Rate/1000: 12 • Significance of Child Abuse in the Navy-2005 • Total “reported” incidents: 2427 • Total Rate/1000: 8.6 • Substantiated Incidents: 1305 • Substantiated Rate/1000: 4.8 U.S. Health Dept of Human Services, Administration of Children and Families, Administration on Children, Youth and Families Children’s Bureau, 2005

11. NAT Intake Form • Physician’s Form • Supplemental Information Sheet • Reporting Checklist • Suspected Child Abuse Report • Checklist for Medical Work-Up for Suspected Child Abuse or Neglect

12. Current Reporting System Staff Education Data Tracking Liaison/ Coordination w/ outside agencies Standard of Care My Questions…

13. NAT Report • Does NMCP utilize a reporting form for outside agencies? • Submitted to: • SAVI • SANE • CPS/APS • Fleet & Family Service Center • Local Police/NCIS/Base Security • Reporting Party (NMCP’s copy)

14. Tracking Abuse • What data needs to be captured? • Who will have access as read-only • Which one person will have the only access to input and update data? • What do we do with the data?

15. Protocol/SOP • Need a clinical practice guideline that is good and accepted by all departments (including TPC & BMCs) and is also respected by the command • Need policy articulation, unification, standardization, and implementation

17. CANAREES • Consolidated • Abuse • Neglect • Assault • Reporting • Electronic • Entry • System

38. Problems with Chores A man told his doctor that he wasn't able to do all the things around the house that he used to do.When the exam was complete, he said, "Now, Doc, I can take it. Tell me in plain English what is wrong with me.""Well, in plain English," the doctor said, "you're just lazy.""Okay," said the man. "Now give me the medical term so I can tell my wife."

39. What’s next?

40. Child Abuse Quality Assurance Team • Mission: CAQAT will be a systems approach to discover factors that will prompt improved identification, intervention, and prevention efforts in similar cases. • Investigate retroactive review of hard data • Data tracking of all child abuse cases presented to NMCP and outlying BMCs • Internal quality assurance of the system and NOT providers • Membership will be by a command appointed letter identifying key players sponsored by department heads of relevant departments

41. Quality Assurance • Record Review • Inpatient (dashboard view) • Outpatient (retro) • Criteria • Different set for patient status

42. NMCP to officially adopt CANAREES as sole domestic violence reporting system Train Provider Staff on CANAREES-PhaseII Develop Clinical Pathways-Phase III Establish a quantitative, measurable, and qualitative tracking tool from CANAREES Collect data work load to justify additional staffing Explore research opportunities The Way Ahead

43. The Prognosis • "Mr. Clark, I'm afraid I have bad news," the doctor told his anxious patient. "You only have six months to live."The man sat in stunned silence for the next several minutes. Regaining his composure, he apologetically told his physician that he had no medical insurance. "I can't possibly pay you in that time.""Okay," the doctor said, "let's make it nine months."

44. We Are Doing It! SANE CPS FAP CPS FAP APS WEB MASTER

45. Any Questions? LCDR Christina Jamieson christina.jamieson@med.navy.mil Comm: 757-953-4476 DSN 377-4476