Pediatric sexual assault education, quality management and research
Clinicians and researchers at Children’s Hospital of Philadelphia (CHOP) are committed to continuously improving the quality of care provided to children and adolescents who are victims of sexual assault. Our research efforts focus on improving the overall outcomes and experience for this vulnerable and high-risk pediatric patient population.
Evidence-based training programs
A large focus of our research and education is in establishing evidence-based training and protocols for pediatric victims of sexual assault that can be applied at institutions nationwide.
We created and deployed an innovative training program for physicians, nurses, advanced practice providers, child life workers and social workers in the ED using mannequin simulation, instructional videos, and peer-to-peer education that is integrated into clinical care. This training process is paired with our clinical pathway and hospital-based quality improvement projects. New evidence, changes in treatment recommendations, and data from our own experience are incorporated as they arise. This allows us to provide the best possible care to patients and serves as a sustainable model that can be replicated at pediatric-serving institutions nationally.
Increasing access to consistent, high-quality care with digital technology
Recognizing the limited access to medical forensic expertise in cases of child sexual abuse, researchers at Safe Place: The Center for Child Protection and Health are leading the innovative use of telemedicine to expand access to the same high level of care for all child sexual abuse patients. We are currently testing the feasibility of “real-time” telemedicine to offer the expertise of the Safe Place team to patients in the exam room, working alongside ED providers.
This patient-centered approach enables us to provide follow-up care without repeating sensitive examinations. A qualitative study of this novel approach demonstrated an overwhelmingly positive view toward the use of real-time telemedicine to support medical and forensic care in the CARE clinics by both patients and their caregivers.
Improving behavioral health services for victims of sexual assault
A substantial proportion of patients who are victims of sexual assault return to the ED for behavioral health services, confirming the vulnerability of this population. Our team continues to improve the behavioral healthcare we provide with the goal of lowering the rate of return by providing real-time outpatient resources and referrals.
With adherence to the recent addition of Act 164, healthcare facilities are required to notify the Department of Health if evidence collection kits are not picked up from their collection site within 72 hours of collection. Collectively, this will improve communication and collaboration, and provide timely attention to the kits.
- Stavas N, Shea J, Keddem S, Wood J, Orji W, Cullen C, Scribano P. Perceptions of caregivers and adolescents of the use of telemedicine for the child sexual abuse examination. Child Abuse Negl. 2018 Nov;85:47-57. doi: 10.1016/j.chiabu.2018.08.009. Epub 2018 Sep 11.
- Schilling S, Deutsch SA, Gieseker R, Molnar J, Lavelle JM, Scribano PV. Improving HIV post-exposure prophylaxis rates after pediatric acute sexual assault. Child Abuse Negl. 2017 Jul;69:106-115. doi: 10.1016/j.chiabu.2017.04.014. Epub 2017 Apr 28.
- Goyal MK, Mollen CJ, Hayes KL, Molnar J, Christian CW, Scribano PV, Lavelle J. Enhancing the emergency department approach to pediatric sexual assault care: implementation of a pediatric sexual assault response team program. Pediatr Emerg Care. 2013 Sep;29(9):969-73. doi: 10.1097/PEC.0b013e3182a21a0d.
- Goyal M, Scribano PV, Molnar J, Mollen C. Sexual Assault in the Child and Adolescent. In: Textbook of Pediatric Emergency Medicine (7th Ed). Fleisher G, Ludwig S (eds), Lippincott, Williams and Wilkins, 2016.