# Presentation: 578532

## Child Death Review Reporting

- From Case Review to Data to Prevention

**Teri Covington, M.P.H**
**Director**
**National Center for Child Death Review**

**Notes:**
Thank you David/Stephanie.  I’d like to turn now to Teri Covington. Who directs the National Center for Child Death Review to learn about efforts to standardize reports from death reviews.     Teri, David told us that States are actively reviewing deaths, identifying risk factors and taking actions to prevent deaths.  How are States reporting out their findings?

## CDR Reporting in States

- 44 States have a CDR case report tool
- 18 States have legislation that requires an annual State report on CDR findings
- 39 States publish an annual report with findings and recommendations
- However, there is no consistency among any State case report tool or State reports

**Notes:**
Thank you Beth, and also thank you David for your excellent overview.   The good news is that 44 States have developed a reporting system to collect data from the individual case reviews.  This includes local case reports completed and submitted to a State CDR program pr State case review repots.  Most of these reports are really quite comprehensive-capturing data on the child, family, circumstances involved in the death and an assortment of risk factors relative to cause of death.  Most States have laws that make this case report a confidential document. 

 A few States don’t do a lot with this data-they may compile it into a data base and may issue special reports by cause of death.  But 18 States have legislation that requires the data be compiled and released as an annual report on child mortality-and even without legislation a total of 39 States routinely release annual reports.  You can find links to many of these repots on our web site.  

The bad news is that there is little consistency among the case report tools and State reports.  When our center was first funded we analyzed all 44 case report tools and found that no two were the same.  This makes it hard to do tabulations and analyses of this rich data source across States.

## Purpose of CDR Case Reporting

- To systematically collect, analyze, and
- report on:
- Child, family, supervisor, and perpetrator information
- Investigation actions
- Services needed, provided, or referred
- Risk factors by cause of death
- Recommendations and actions taken to prevent deaths
- Factors affecting the quality of the case review

**Notes:**
Well Teri, do the States share a common purpose in why they collect case review data.

A.  That they do.  Despite there not being a common tool, almost all of the States are collecting pretty comprehensive information from the reviews.  The source of most of this information comes from a variety of records that are shared at the review meeting, including police reports, medical examiner/coroner reports, medical records from emergency departments, hospitals and health clinics, death certificates, social services, etc.   But these reports And then the reports also capture the findings from the team, including types of services needed, the specific risk factors identified.  For example, a team may be reviewing a teen firearm  suicide death-the report usually will capture not only general information on the child, but such things as the type of weapon, where it was stored, if it was locked, the teens previous mental health history, known prior attempts, and precipitating events leading to the suicide.  Then the report tool will capture the specific recommendations and actions taken by the team.  So you can see, there is great potential through the CDR case reports to really understand child deaths.

## How Do Teams Use Their CDR Data?

- Local teams present annual findings to community groups to push for local interventions
- Teams use data as a quality assurance tool for their reviews
- State teams review local findings to identify trends, major risk factors and to develop recommendations
- State teams use findings to develop action plans based on their recommendations
- Local teams and States use their reports to keep or increase CDR funding
- National groups use State and local CDR findings to advocate for national policy and practice changes

**Notes:**

So then, what are the States doing with their case reports?

Well, the most successful teams collect the case reports into a data base and analyze the findings.  This is usually done on a State level through the heath department or social services.  The teams use the data at the local level and  at the State level to advocate for changes to policy and proactive.  Teams even use their findings to demonstrate the utility of CDR and we have examples where the reports helped keep or increase funding.

Our next presenter, Mary Overpeck, will provide you with examples of how national organizations have obtained data from individual States to develop more comprehensive understanding of deaths to guide national policy and practice.

## A New Case Report System

**Notes:**
Your center has been working then to develop a standardized reporting system for States.  Can you tell us about this effort and what you've been able to accomplish.

A.  Yes, a substantial part of our grant from the bureau has been devoted to the development of a multi-State CDR case reporting system.  We put out a call to State coordinators and other CDR supporters, and ended up with a 30 person work group representing 18 States.  Over a two year period we assessed the 44 case report tools already out there, identified common data elements, made decisions as to the data elements we all felt were important to collect from the reviews, and then created a standard tool, data dictionary and 32 “standardized” reports that we felt should be generated from a data base.  We then developed software, and are still completing this development, to make this system a web based reporting system.

## The Child Death Review Case 

- Reporting System

- From Case Review to Data to Action

**Step 1: Complete case review of child death**

**Step 2: Complete CDR Case Report online at www.cdrdata.org**

**Step 3: Send Report through Web, to servers at MPHI**

**Step 4: Servers sort and store data and permit access according to State requirements**

**Step 5: State and local teams and national CDR download standardized reports and/or download data to create custom reports**

**Step 6: Reports and data are used to advocate for actions to prevent child deaths and to keep children healthy, safe, and protected**

**Notes:**
Q.  For those of us not familiar with web based reporting and data systems, can you give us an overview of the new case reporting system's web functioning?

## Slide 7

## State Level Standardized Reports

**Notes:**
So states using this system will be able to enter and edit case data, and then download their data for their own analysis.  But you also mentioned that the system will generate standardized reports.  How will this work and what types of reports are going to be available?

## Standardized Reports – State and Local Level

**Demographics (Ethnicity/Race and Age Group by Sex) **
**Infant Death Information **
**Manner and Cause of Death by Age Group **
**Investigation Information **
**Motor Vehicle and Other Transport Death Demographics **
**Vehicle Type Involved in Incident and Position of Child **
**Risk Factors of Young Drivers (Ages 14********21) Involved in the Crash **
**Motor Vehicle Protective Measures **
**Fire Death Demographics **
**Factors Involved in Fire Deaths **
**Drowning Death Demographics **
**Factors Involved in Drowning Deaths **
**Suffocation or Strangulation Death Demographics **
**Weapon Death Demographics **
**Safety Features and Storage of Firearms Used in Incident **
**Owner and Use of Weapon at Time of Incident **
**Poisoning Death Demographics **

**Factors Involved in Poisoning Deaths**
**Sleep-Related Death Demographics **
**Sleep-Related Deaths by Cause **
**Circumstances Involved in Sleep-Related Deaths **
**Factors Involved in Sleep-Related Deaths **
**Sleep-Related Deaths by Acts that Caused or Contributed to Death **
**Acts of Omission/Commission Demographics **
**Acts of Omission/Commission Child Abuse Information **
**Acts of Omission/Commission Child Neglect Information **
**Acts of Omission/Commission Assault Information (Not Child Abuse) **
**Acts of Omission/Commission Suicide Information **
**Deaths by Manner and Cause by Preventability **
**Team Prevention Recommendations **
**Review Team Process**

## Using the National MCH Center System

- Participating

- Considering

- In Process

**Notes:**
This system is in its pilot stage, or beta test.  What States are currently participating?

## Future Plans

**Beta Test**
- Assessment completed September 2006
- Beta test completed December 2006
- New version ready January 2007
**Release Of Data**
- Data sharing protocols under development
- Aggregate data available in 2007

**Notes:**
When do you anticipate rolling out the system for others, and when will data be available for the public from the system?

## To request a login to the demonstration site, email:info@childdeathreview.org

- To request a login to the demonstration site, email:info@childdeathreview.org

**Notes:**
Q.  Is it possible for any of our listeners to view the system and see what type pf data elements you have in the form and to view the types of standardized reports that will eventually be available if a listener would like to see the system functioning as a web based system. 

A.  Yes, there is a demo site available for those who would like to examine the system closer.  If you are interested, send your name and email address to info@childdeathreview.org and you will be provided with a username and password.  However, if you chose to enter data, do not enter actual case data as the security of the demo site is not as extreme as the live site.