A simple approach to improve recording of concerns about child maltreatment in primary care records: Developing a quality improvement intervention

dc.contributor.authorWoodman, J., Allister, J., Rafi, I., de Lusignan, S., Belsey, J., Petersen, I., & Gilbert, R.
dc.date.accessioned2014-08-19T16:21:53Z
dc.date.available2014-08-19T16:21:53Z
dc.date.issued2012
dc.description.abstractBackground: Information is lacking on how concerns about child maltreatment are recorded in primary care records. Aim: To determine how the recording of child maltreatment concerns can be improved. Design and setting: Development of a quality improvement intervention involving: clinical audit, a descriptive survey, telephone interviews, a workshop, database analyses, and consensus development in UK general practice. Method: Descriptive analyses and incidence estimates were carried out based on 11 study practices and 442 practices in The Health Improvement Network (THIN). Telephone interviews, a workshop, and a consensus development meeting were conducted with lead GPs from 11 study practices. Results: The rate of children with at least one maltreatment-related code was 8.4/1000 child years (11 study practices, 2009–2010), and 8.0/1000 child years (THIN, 2009–2010). Of 25 patients with known maltreatment, six had no maltreatment-related codes recorded, but all had relevant free text, scanned documents, or codes. When stating their reasons for undercoding maltreatment concerns, GPs cited damage to the patient relationship, uncertainty about which codes to use, and having concerns about recording information on other family members in the child’s records. Consensus recommendations are to record the code ‘child is cause for concern’ as a red flag whenever maltreatment is considered, and to use a list of codes arranged around four clinical concepts, with an option for a templated short data entry form. Conclusion: GPs under-record maltreatment-related concerns in children’s electronic medical records. As failure to use codes makes it impossible to search or audit these cases, an approach designed to be simple and feasible to implement in UK general practice was recommended. (Author Abstract)en_US
dc.identifier.citationWoodman, J., Allister, J., Rafi, I., de Lusignan, S., Belsey, J., Petersen, I., & Gilbert, R. (2012). A simple approach to improve recording of concerns about childmaltreatment in primary care records: developing a quality improvement intervention. British journal of general practice, 62(600), e478-e486.en_US
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3381274/pdf/bjgp62-e478.pdf
dc.identifier.urihttp://hdl.handle.net/11212/1658
dc.language.isoen_USen_US
dc.publisherBritish Journal of General Practiceen_US
dc.subjectchild abuseen_US
dc.subjectelectronic medical recordsen_US
dc.subjectprimary careen_US
dc.subjectgeneral practiceen_US
dc.subjectInternational Resourcesen_US
dc.subjectUnited Kingdomen_US
dc.subjectresearchen_US
dc.subjectEnglanden_US
dc.titleA simple approach to improve recording of concerns about child maltreatment in primary care records: Developing a quality improvement interventionen_US
dc.typeArticleen_US

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