Child maltreatment detection practices in Israeli pediatric emergency departments: A national study

Background: Healthcare is a prominent governmental sector responsible for addressing and preventing child maltreatment. Yet underdetection of child maltreatment in health systems is a longstanding international concern. Objective: This is the first national scale study investigating child maltreatment detection and management practices at hospital pediatric emergency departments in Israel, from the staff point of view. Given the current technological era, particular attention was given to hospital staff experiences using computerized systems. Participants and setting: Participants were 179 healthcare professionals (46 % physicians, 41 % nurses, and 14 % social workers) employed in 22 hospitals around the country. Methods: Participants completed an online questionnaire. Results: Findings indicate several patterns suggesting inadequate and insufficient practice, including underdetection of suspected child maltreatment cases and low confidence in identifying possible child sexual abuse. Being a parent was significantly and negatively associated with staff confidence in detecting physical abuse (β = −0.17, p = .046), sexual abuse (β = −0.19, p = .030), and neglect (β = −0.19, p = .036). The most common practice reported when faced with cases of suspected child maltreatment was to consult with multiprofessional staff members. Although most participants reported having prior academic or departmental training in child maltreatment, findings suggest training did not play a notable role in practice. A key finding was the underuse of computerized systems in hospitals to support practice. Conclusions: Evidence suggests unsatisfactory quality of available computer materials and functions. Policymakers should mandate basic effective computing experience for staff members to improve practice.