Factors that influence the effectiveness of child protection teams.
OBJECTIVE
More than $55 million is spent on hospital-based child protection teams (CPTs) annually, but there is no consensus on what makes CPTs effective. The objective of this study was to create expert consensus on tasks that CPTs should perform and factors that contribute to effectiveness.


METHODS
A modified Delphi approach was used to create expert consensus among professionals with experience working on or with hospital-based CPTs. Three initial rounds of surveys were conducted; a first round of open-ended questions generated topics related to CPT tasks and factors related to team effectiveness. A Likert scale (range: 1-7) determined rank. In the fourth round, participants ranked the top 5 variables associated with effectiveness.


RESULTS
Twenty-six (90%) of 29 participants completed the first 3 rounds, and 20 (67%) completed the final ranking. Experts believed that CPTs should provide communication of findings to appropriate agencies (mean Likert score: 7.0), court testimony (7.0), medical consultations (6.9), multidisciplinary case review (6.6), and forensic interviews (6.0). CPT success should be determined by professionals who use CPT services (6.6) and CPT members (6.5). Variables that were ranked most often as critical to effectiveness included interdisciplinary collaboration (95% of participants), provision of resources (80%), and team collegiality (75%). Variables that were ranked as most detrimental included inadequate staffing (85%) and lack of collegiality (80%).


CONCLUSIONS
A multidisciplinary team working in a collegial atmosphere seems to be the major key to CPT effectiveness. In addition to providing services, CPTs should focus on improving collegiality and interdisciplinary collaboration and should seek performance feedback from referring professionals and CPT members.
Kistin
Caroline J
CJ
Boston University School of Medicine/Boston Medical Center, Division of General Pediatrics, Boston, MA 02118, USA. caroline.kistin@bmc.org
Tien
Irene
I
Bauchner
Howard
H
Parker
Victoria
V
Leventhal
John M
JM
D001291:Attitude of Health Personnel; D002648:Child; D002649:Child Abuse / Q000517:prevention & control*; D002651:Child Advocacy; D002669:Child Welfare; D002675:Child, Preschool; D003697:Delphi Technique; D005260:Female; D017408:Guidelines as Topic; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration; D010818:Practice Patterns, Physicians'; D011322:Primary Prevention / Q000458:organization & administration*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014481:United States