2019-2020 CHAMP Program Annual Summary

Annual Summary PDF (printer friendly version)

CHAMP continues to be seen as a source for quality professional education regarding child abuse. The webcasts, online coursework, website features like Test Your Knowledge, and downloadable practice recommendations and other clinical resources draw a large number of visitors. Comments include:

• Great, relevant material....I really enjoyed this!!

• This is such a valuable program!

• Great job – I really enjoyed this topic. I feel that it is much needed and not something that is discussed frequently.

• This was certainly the best presentation on MSBP that I have ever attended

• Loved this lecture. Very helpful. Always appreciate the case studies and how they are managed

• Brilliant! Thank you, excellent presenter!

• This was a great presentation – I appreciate having a legal based webinar

Completed Tasks

Educational Webcasts

There were six CHAMP webcasts this grant year:

1. October 16, 2019. Social Media Facilitated Sexual Assault by Ann Botash, MD
2. November 13, 2019. Ongoing Pediatric Health Care for the Child Who Has Been Maltreated by Lori Legano, MD
3. December 18, 2019. Rooted in Compassion: Self-Care for the Child Abuse Professional by Mandy O’Hara, MD
4. January 15, 2020. Improving the Rate of Follow-up Skeletal Survey (FUSS) Completion by Iram Ashraf, MD
5. February 12, 2020. Medical Child Abuse by Ann Lenane, MD
6. March 11, 2020. Perils, Pitfalls, and Protections in Child Abuse Pediatrics , in collaboration with APSAC-NY, by Jason R. Corrado, Sr., Esq.

Drs. Botash, Legano, O’Hara and Lenane are American Board of Pediatrics certified child abuse pediatricians. Dr. Ashraf is a second year child abuse pediatrics fellow at SUNY Upstate Medical University and a Board certified pediatrician. Mr. Corrado is an attorney specializing in medical practice and hospital law. All webcasts bring research-based information to the child abuse professionals of NYS and provide an opportunity for attendees to get answers from an expert.

Webcast attendees identified themselves as being physicians, nurse practitioners, physician assistants and registered nurses working in pediatrics, emergency medicine and family medicine, many with SANE/SART/SAFE designation, and also social workers and non-medical members of multidisciplinary teams. There was a total of 916 registrants for the webcasts. Of those who registered, 396 applied for Continuing Medical Education (CME) credit. Both the webcasts and CME credits (one credit per webcast) are free to participants.

Attendees evaluated all webcast presenters as excellent and the content as being clear and helpful. From the responses to the surveys at the end of the webcasts, attendees planned to make significant changes in their practice, including:

• Better council parents/patients about social media sites and their use of GPS
• Change questioning techniques with adolescents
• Will work with hospital system to improve follow-up
• Put together a check list of things for primary care pediatricians to carry out with abused kids still with their parents or returned to their parents
• Conduct complete debriefing of staff following a difficult case
• To take note of my stresses and use relaxation techniques
• Take more time to understand my feelings about child abuse
• Recognition of injury and fractures that indication need for skeletal surveys
• I will work with institution to develop a QI project on repeat skeletal survey
• More thorough review of outside medical records for discrepancies
• To work better in a multidisciplinary approach with subspecialists to identify MCA
• Will share the points from this presentation with all the physicians and nurse practitioners in my pediatric group
• Better charting to support the report
• Collaborate with risk management

The Evaluating Child Sexual Abuse Course

The online course Evaluating Child Sexual Abuse (ECSA) continues to be an effective educational tool for pediatricians, emergency department physicians, physician assistants, nurse practitioners and SANEs. This grant year 173 professionals registered for the course. By June 30, 90 had passed the 100-question test. Of those who passed the test, 14 applied for and received CME credit and 5 applied for Maintenance of Certification (MOC) credit. Although the course is free, there is nominal charge for the 12 CME credits and 12 ABP MOC points.

The ECSA course was originally created to be the first step for New York State medical professionals to become CHAMP Network Members. Its use has expanded to being part of child abuse training for medical residents, fellows and self-preparation for certification examinations. More than twenty trainees from St. Joseph's Hospital Health Center and SUNY Upstate Medical University, Syracuse, NY, including family medicine residents, pediatric residents and a pediatric emergency medicine fellow completed ECSA as a part of their rotation in child abuse with CARE clinic this year. CHAMP coursework was shared with pediatric listservs nationally as an option for online coursework for pediatric residents during COVID.

From the launch of the course in September 2011 through June 2020, there have been 1517 registrants. Of those, 733 have passed the test and 321 have applied for and received CME credit.

Other CHAMP Website Resources

This grant year the CHAMPprogram.com website drew 285,000 visitors. In addition to viewing web pages, visitors downloaded a significant number of resources. Tracking the number of downloads from the top 150 resources offered on the website, there were 31,000 downloads. That total includes 3,000 Practice Recommendations related to Triage, Testing and Treatment, Skeletal Survey, and Photographic Documentation and 1,800 Guidelines related to Evaluation of Physical Abuse, Evaluation of Sexual Abuse and Trauma-Informed Care. The 24 questions and answers of Test Your Knowledge were visited over 58,000 times and the individual questions and answers of What Would You Do? regarding nine child trafficking cases were visited 1,500 times.

Statistics for the ChildAbuseMD.com website that posts the searchable webbook Child Abuse Evaluation & Treatment for Medical Providers had a total of more than 60,000 visitors.

Since ChildAbuseMD.com was launched in mid-2005 and CHAMPprogram.com was launched in mid-2007, there have been over five million visitors to the websites.

CHAMP Network Members

This grant year two medical professionals became new CHAMP Network Members by successfully passing the Evaluating Child Sexual Abuse course and completing a clinical observership. Emmy Stevenson, NP, completed an observership with Ann Lenane, MD, and William McGill, PA, completed an observership with Alicia Pekarsky, MD. Twenty-two New York State counties have one or more CHAMP Network Members: Albany, Broome, Cayuga, Chemung, Erie, Fulton, Herkimer, Jefferson, Kings, Madison, Nassau, Oneida, Onondaga, Otsego, Saratoga, St. Lawrence, Schenectady, Schuyler, Ulster, Warren, Washington and Westchester.

To remain on the Active Network Member roster, Members must attend at least three CHAMP educational webcasts annually. There were 28 Active Network Members at the start of the year, July 1, 2019. Of those, 25 completed the continuing educational requirements. Three members retired or left the child abuse pediatrics field. Two new providers completed an observership and coursework requirements to become network members. As a result, there were 27 CHAMP Active Network Members as of June 30, 2020.

Other Educational Opportunities

CHAMP education is an integral part of SUNY Upstate Medical University and the Maimonides Medical Center Child Abuse Pediatrics Fellowship programs. The educational webcasts, the ECSA online course and weekly case conferences are part of the fellowship curriculum. A journal club conference on human trafficking was held collaboratively this past year between the two programs.

The CARE program, a CHAMP Center of Excellence in Syracuse, provided scheduled learning experiences and rotations for 21 Pediatric and Family Medicine residents and a Pediatric Emergency Medicine fellow.

Linda Cahill, MD, and Jamie Hoffman-Rosenfeld, MD, at the J.E. and Z.B. Butler Child Advocacy Center of the Children's Hospital at Montefiore, provided residents with an opportunity to complete the CHAMP Residency Training Program. Residents who complete this program can become CHAMP Members when they are licensed to practice in NYS by submitting three of their recent child sexual abuse cases for review by a CHAMP expert.

In April 2020, CHAMP launched a new course, Caring with Compassion: A Reflection Course to Foster Well-Being in Child Abuse Medical Providers, https://www.champprogram.com/compassion/compassion.shtml. Mandy A. O’Hara, MD, MPH, TCTSY-F, a CHAMP Mentor and an Assistant Professor of Pediatrics at Columbia University Medical Center, developed the course. It provides an opportunity to pause and expand self-knowledge and perspective, a step that can deepen self-compassion. Accompanying the course is a 12-minute Trauma Sensitive Yoga Chair Practice video that uses movement to explore and address secondary traumatic stress that is often held in the body. As of June 30, 119 people had interacted with this course.

Recommendation

Pediatric providers have been stressed by the pandemic. In addition to dealing with stress of medical protocols that are required, they are trying to help overstressed families and educate to prevent child abuse in uncertain times. As part of the provider side of trauma-informed care, check-ins by members of a care team are part of reducing their secondary traumatic stress. Pediatric providers may not have had opportunities to share their observations and concerns with other professionals. A survey-based opportunity with shared discussion would benefit both providers and NYS families, and may lead to the development of newly identified best practices, which can then be shared widely via CHAMP.