Field Placement: Cedars-Sinai Medical Center -- Community Child Health Programs/Primary Care Pediatrics Division
Location: Los Angeles, CA
Preceptor: Cynthia Landes, MPH, MA and Neal Kaufman, MD, MPH
Student Name: Rosalinda Valdez
Year: 2003

Suspected Child Abuse and Neglect Team

In the United States, it is estimated that each year more than three million children are reported as having been physically abused or neglected and child abuse and neglect results in direct costs of over $94 million. Child abuse is defined as a physical injury that is inflicted by other than accidental means. Child abuse includes physical abuse, physical neglect, sexual abuse, and emotional abuse. In addition to physical injuries, abused and neglected children often suffer a wide range of physical, emotional and developmental problems. In 2002, the Los Angeles Department of Children and Family Services (DCFS) received 161,638 reports of suspected child abuse and/or neglect of which 59% receiving an investigative response were substantiated or deemed inconclusive.

Hospitals are often the first point of contact for an abused or neglected child. In an effort to enhance the identification, reporting and case management of child abuse and neglect, many hospitals have enacted consultative Suspected Child Abuse and Neglect (SCAN) teams. SCAN teams differ in their composition, but generally members include nurses, social workers, physicians and others with expertise in child abuse and neglect thus their knowledge and experience place them in an optimal position to discriminate as to whether the presented injuries are consistent or inconsistent with child abuse. Tasks of SCAN teams include but are not limited to case review of all child abuse and neglect reports, coordination of treatment planning, maintaining a central log of cases, research, and providing training and education to other professionals and the community. A team also provides guidance for interviewing the child and parent, clinical studies needed and forensic medical collection.

Cedars-Sinai Medical Center (CSMC), a nonprofit, independent hospital in Los Angeles, reports approximately 12 cases of suspected child abuse and neglect per month. In an effort to explore methods to enhance the effectiveness and quality of services provided by CSMC to suspected child abuse and neglect victims via their SCAN team, the objectives of this project included identifying sources of SCAN team information, conducting key informant interviews, identifying barriers to effective CSMC SCAN team implementation, and obtaining written protocol, procedures and sample documents from other SCAN teams. Based on these activities, secondary data, and professional literature, recommendations for activities and tools that could enhance the effectiveness and quality of services provided by the CSMC SCAN team were developed. This project took place from June to August 2003 under the supervision of the Coordinator of the Community Child Health Programs and the Director of Primary Care Pediatrics.

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