Best Practices and Areas of Improvement in Child Death Review: A qualitative analysis to inform policy change in Illinois

Abstract

Background: Child Death Review teams (CDRTs) emerged as a professional response to rising public awareness of child abuse and maltreatment. CDRTs are multidisciplinary groups that review data on child fatality and make reports to inform prevention initiatives in communities. In Illinois, child death review is mandated to review only deaths of children age 17 and younger if the child was a ward of the Department of Children and Family Services (DCFS), involved in a pending investigation, or whose death was reported to the DCFS hotline due to suspicion of abuse and neglect. Objective: This study aimed to establish understanding of best practices and areas of improvement in child death review in order to inform policy recommendations for Illinois. Methods: 21 professionals who serve on child death review teams agreed to participate in this qualitative research study. Interviews were conducted using a semi-structured open-ended format. Interviews were transcribed and then hand coded for recurring themes, similarities, and differences among participants. Results: Participants included child abuse pediatricians (n=2), state child death review coordinators (n=4), nurses (n=3), leaders at the Department of Children and Family Services (n=2), therapists (n=3), public health workers (n=4) and social workers (3). Participants identified procedural strengths that improved their review process, emphasized the importance of collaboration, and mentioned that when teams have non-adversarial discussions they are most successful. Participants identified education and the lack of data, legislation and funding as areas of improvement. Unanimously, participants were in support of a comprehensive child death review program where deaths from all causes are reviewed. Conclusion: Respondents of this study identified strengths, best practices, areas for improvement, and unanimously agreed that a comprehensive child death review model whereby all child deaths are reviewed best supports the prevention of future child deaths. Reviewing all child deaths of all causes centers the CDRT on prevention, which allows for greater focus on the leading causes of death and more specific prevention interventions. Illinois would benefit from adopting this comprehensive model to discover accurate trends regarding patterns of death in the communities.

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