Background and Aims The number of children identified as victims of child abuse in the Emergency Department represent only the tip of the iceberg. The “Hague-protocol” takes a new and successful approach to the recognition of child abuse at the E.D.
Methods These new guidelines call for notification to the Reporting Center for Child Abuse and Neglect when an adult patient who is responsible for children at home, visits the E.D. because of either 1) Substance abuse 2) Suicide attempt 3) Domestic violence. A before and after study was done at E.D.’s of five hospitals in an urban region in the Netherlands.
Results In the two years prior to the introduction of the protocol, a total of 4 parents were reported. After the guidelines were issued in 2007 the number of suspected child abuse cases reported to the Reporting Center, based on parental characteristics, rose substantially. A total number of 107 cases were reported in 2008, 149 cases in 2009, and 126 cases in 2010. Results indicate that child abuse was confirmed in the large majority (92%) of the reported cases. In 5% of the cases child abuse could not be confirmed and in 3% of the cases it was concluded that there was no child abuse.
Conclusion The Hague-protocol can substantially improve and increase the detection rate of child abuse cases via the E.D. Parental characteristics can be strong predictors of child abuse, and can be included in E.D.’s guidelines to help identify new cases of child abuse.