Improving Physical Abuse Documentation and Photography through a Remote Peer Review Intervention

Rebecca L Moles; John Melville; Kim Martinez; Vincent Palusci

doi:10.1097/pq9.0000000000000477

Improving Physical Abuse Documentation and Photography through a Remote Peer Review Intervention

Pediatr Qual Saf. 2021 Sep 24;6(5):e477. doi: 10.1097/pq9.0000000000000477. eCollection 2021 Sep-Oct.

Authors

Rebecca L Moles¹, John Melville², Kim Martinez³, Vincent Palusci⁴

Affiliations

¹ Division of Suspected Child Abuse and Neglect, Connecticut Children's, Hartford, Conn.
² Division of Child Abuse Pediatrics, Medical University of South Carolina, Charleston, S.C.
³ Midwest Regional Children's Advocacy Center, Edina, Minn.
⁴ Department of Pediatrics, New York University Grossman School of Medicine, New York, N.Y. 10016.

Abstract

Child Abuse Pediatrics is a small and geographically dispersed specialty. This article reports on an intervention to improve written and photodocumentation quality and uniformity in suspected child physical abuse cases, using a remote, de-identified case review system.

Methods: In each cycle, participants submitted de-identified medical reports and photographs for review by a child abuse pediatrics expert. Experts evaluated 3 cycles of 5 cases using a novel rubric and assigned quality interventions for the participants based on their scores.

Results: 15 of 16 participants improved scores between cycles 1 and 3 (78% versus 89%, P < 0.001). All participants rated the program as helpful and would recommend it to a colleague.

Conclusion: A quality improvement project administered via the internet improves the quality and uniformity of written and photographic documentation in child physical abuse evaluations.