Fatality Review Team Weekly September 30 - October 4, 2019

Thu Oct 3 10:52:40 PDT 2019

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  Fatality Review Team News                  September 30 - October 4, 2019

Pediatric Mental Health Care in the Emergency Dept

CDC: Prevent Adverse Childhood Experiences (ACEs)

National Fatality Review Case Reporting System

Critical Crossroads: Pediatric Mental Health Care in the Emergency Department
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Critical Crossroads Toolkit Benefits Hospitals

The Critical Crossroads<http://links.govdelivery.com:80/track?type=click&enid=ZWFzPTEmbXNpZD0mYXVpZD0mbWFpbGluZ2lkPTIwMTkwNzI2Ljg1MDk3NTEmbWVzc2FnZWlkPU1EQi1QUkQtQlVMLTIwMTkwNzI2Ljg1MDk3NTEmZGF0YWJhc2VpZD0xMDAxJnNlcmlhbD0xNjc4MDM2OSZlbWFpbGlkPWxsdWR3aWdAaHJzYS5nb3YmdXNlcmlkPWxsdWR3aWdAaHJzYS5nb3YmdGFyZ2V0aWQ9JmZsPSZtdmlkPSZleHRyYT0mJiY=&&&103&&&https://www.hrsa.gov/sites/default/files/hrsa/critical-crossroads/critical-crossroads-tool.pdf> toolkit is a new resource to help hospital emergency departments better manage and coordinate care for children and adolescents in mental health crisis.

You can tailor the resources to your specific needs, patient population, and community.

During the webinar, you will learn why we developed the toolkit and how to use it. Presenters include:

  *   Michael D. Warren, MD, MPH, FAAP, HRSA Associate Administrator for Maternal and Child Health
  *   Tom Morris, MPA, HRSA Associate Administrator for Rural Health Policy

Can you use the Critical Crossroads toolkit?

Anyone who establishes policies and protocols in emergency departments can use this toolkit. This includes:

  *   hospital administrators
  *   social workers
  *   pediatric care coordinators
  *   physicians and nurses
  *   mental health providers

Download the Critical Crossroads toolkit <http://links.govdelivery.com:80/track?type=click&enid=ZWFzPTEmbXNpZD0mYXVpZD0mbWFpbGluZ2lkPTIwMTkwNzI2Ljg1MDk3NTEmbWVzc2FnZWlkPU1EQi1QUkQtQlVMLTIwMTkwNzI2Ljg1MDk3NTEmZGF0YWJhc2VpZD0xMDAxJnNlcmlhbD0xNjc4MDM2OSZlbWFpbGlkPWxsdWR3aWdAaHJzYS5nb3YmdXNlcmlkPWxsdWR3aWdAaHJzYS5nb3YmdGFyZ2V0aWQ9JmZsPSZtdmlkPSZleHRyYT0mJiY=&&&104&&&https://www.hrsa.gov/sites/default/files/hrsa/critical-crossroads/critical-crossroads-tool.pdf>

________________________________

Critical Crossroads is a product of a partnership between HRSA's Maternal and Child Health Bureau - Emergency Medical Services for Children Program and Federal Office of Rural Health Policy.

[Centers for Disease Control and Prevention. Your online source for credible health information.]

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Prevent Adverse Childhood Experiences (ACEs)
Implement Strategies to Prevent ACEs with CDC's Latest Resource

CDC released Preventing Adverse Childhood Experiences (ACEs):Leveraging the Best Available Evidence<https://t.emailupdates.cdc.gov/r/?id=h372a517,30ea69a,30e817f> to help states and communities prioritize efforts to prevent ACEs.

This resource features six strategies to prevent ACEs drawn from the CDC Technical Packages to Prevent Violence<https://t.emailupdates.cdc.gov/r/?id=h372a517,30ea69a,30e8180>:

  *   Strengthen economic supports for families
  *   Promote social norms that protect against violence and adversity
  *   Ensure a strong start for children helping to pave the way for them to reach their full potential
  *   Teach skills to help parents and youth handle stress, manage emotions, and tackle everyday challenges
  *   Connect youth to caring adults and activities
  *   Intervene to lessen immediate and long-term harms
These strategies focus on changing norms, environments, and behaviors in ways that can prevent ACEs from happening in the first place as well as to lessen their harms when they do occur. The strategies are intended to work in combination and reinforce each other to achieve the greatest impact.

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Spread the Word

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Adverse Childhood Experiences are preventable, not inevitable. Get the strategies needed to help stop ACEs from happening in your community. Check out new report: Preventing Adverse Childhood Experiences (ACEs): Leveraging the Best Available Evidence. go.usa.gov/xVdMt<https://t.emailupdates.cdc.gov/r/?id=h372a517,30ea69a,30e8181>

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Adverse Childhood Experiences are preventable, not inevitable. Check out new report on stopping ACEs from happening in the first place - Preventing Adverse Childhood Experiences (ACEs): Leveraging the Best Available Evidence. #VetoViolence go.usa.gov/xVdMt<https://t.emailupdates.cdc.gov/r/?id=h372a517,30ea69a,30e8182>

Learn More

  *   CDC's Technical Packages for Violence Prevention<https://t.emailupdates.cdc.gov/r/?id=h372a517,30ea69a,30e8183>
  *   Implementing the Technical Packages with Violence Prevention in Practice<https://t.emailupdates.cdc.gov/r/?id=h372a517,30ea69a,30e8184>
  *   CDC's Division of Violence Prevention<https://t.emailupdates.cdc.gov/r/?id=h372a517,30ea69a,30e8185>

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Centers for Disease Control and Prevention
1600 Clifton Rd   Atlanta, GA 30333   1-800-CDC-INFO (800-232-4636)   TTY: 888-232-6348

Data Tip: Please check your bookmarks for National Fatality Review Case Reporting System!

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Please note that https://www.cdrdata.org<http://r20.rs6.net/tn.jsp?f=001lDYOgZQvAGQ_3SeJG0BWFOGRgDhIqMHC0fklef5c43BDj96T57fBOeOHY-JYodYDt5bnn1xw3uB1gsOt7fsuZHqBR1yEUFxt0e47FIAP47dlr4sUjbJyHS0TtZg3mn0ZT3ef97pRla_yM_X6zA8pOg==&c=6nBKsN837oRlP91hkA5Czk2gP9kNZPqw03YOAXzapPlj9TbsjI3d8Q==&ch=DXgnukiasAado1O12Ll6Qd7foz18Lk_NCa0pRNgMRKr7b2pl3kaUKA==> has become https://data.ncfrp.org<http://r20.rs6.net/tn.jsp?f=001lDYOgZQvAGQ_3SeJG0BWFOGRgDhIqMHC0fklef5c43BDj96T57fBOeOHY-JYodYDBUxFP2J-fYEfT93DnIIu4xmCW9Kge7A7umXpsXLwcXdGQrP9FGyfZLrCaNI83ZEWavgiyT_VCwJyKf_TCpjXiQ==&c=6nBKsN837oRlP91hkA5Czk2gP9kNZPqw03YOAXzapPlj9TbsjI3d8Q==&ch=DXgnukiasAado1O12Ll6Qd7foz18Lk_NCa0pRNgMRKr7b2pl3kaUKA==>. If you have the data entry site bookmarked, please check to make sure it says https://data.ncfrp.org<http://r20.rs6.net/tn.jsp?f=001lDYOgZQvAGQ_3SeJG0BWFOGRgDhIqMHC0fklef5c43BDj96T57fBOeOHY-JYodYDBUxFP2J-fYEfT93DnIIu4xmCW9Kge7A7umXpsXLwcXdGQrP9FGyfZLrCaNI83ZEWavgiyT_VCwJyKf_TCpjXiQ==&c=6nBKsN837oRlP91hkA5Czk2gP9kNZPqw03YOAXzapPlj9TbsjI3d8Q==&ch=DXgnukiasAado1O12Ll6Qd7foz18Lk_NCa0pRNgMRKr7b2pl3kaUKA==>. If you are still using cdrdata.org, it will no longer work as of February 2020.

Youth firearm suicide study published in Journal of Behavioral Medicine

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"Firearm Suicide among Youth in the United States, 2004-2015<http://r20.rs6.net/tn.jsp?f=001lDYOgZQvAGQ_3SeJG0BWFOGRgDhIqMHC0fklef5c43BDj96T57fBOeOHY-JYodYDutTmpsSLZl2zTLN6CbFRJc1n4Z3aQldWG8NqavDajkueaPagx5_oWp4zoKibqOx41Xei5vnoV8_EYNu2ClI883PKcHzr-n4g-u4j6IoDzqcj4GXZ5wVP7c4zJHJ9gyOytr3PLwY7JPo=&c=6nBKsN837oRlP91hkA5Czk2gP9kNZPqw03YOAXzapPlj9TbsjI3d8Q==&ch=DXgnukiasAado1O12Ll6Qd7foz18Lk_NCa0pRNgMRKr7b2pl3kaUKA==>" was published in the Journal of Behavioral Medicine on August 1st. Patricia Schnitzer, Heather Dykstra, Theodore Trigylidas, and Richard Lichenstein were contributing authors. The study examined child death review data in the National Fatality Review-Case Reporting System (NFR-CRS) of firearm suicide deaths of children ages 10-18 where the suicide-specific section in the case report tool was complete, providing rich contextual information for analysis.

Of the 1388 suicide deaths included in the sample, 36% of the children had talked about, threatened, or attempted suicide prior to their death; these cases were categorized as at "greater risk" for suicide. The study concluded that firearms used by children in this "greater risk" category were less likely to be stored in a locked location than firearms used by children who had not previously talked about, threatened or attempted suicide.

Access to firearms is a significant preventable risk factor for youth suicide, and this important study maximizes the use of CDR data to more effectively inform the field of injury prevention professionals about levels of risk and exposure to unsecured firearms. Congratulations!

Data Quality Summary Reports coming in September

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The National Center will release the 4th annual Data Quality Summary Reports in September, featuring data on deaths that occurred in 2017 and are entered into the National Fatality Review-Case Reporting System (NFR-CRS).

This report, prepared for each state that records 30 or more deaths occurring during the report year, shows the percent of missing and unknown data for the CDR priority variables for monitoring data quality. This year the report has been updated, with input from the Data Quality Workgroup, in an effort to make it more user-friendly. These updates include the addition of timeliness variables as well as several new tables that display the data in various ways (e.g., percent missing and unknown combined, or Core variables only.)

Dawn Porter (pictured), Arkansas' Infant and Child Death Review Program Coordinator, has used her data quality summary to build data collection and data entry capacity among her local coordinators. She has focused her training efforts on the Core "High 5" and "Low 5" variables--the five variables for which there are the highest and lowest rates of missing and unknown responses in the National Fatality Review-Case Reporting System (NFR-CRS). Recognizing it takes a significant investment of time and effort to help build data capacity, she expressed the value of doing so: "If you don't have the data, you can't make recommendations because you don't know all the circumstances."

The first Data Quality Summary Reports were provided for cases of fatalities that occurred in 2014 and were distributed in 2016.

Arkansas has seen great success since beginning this focused work, including significant decreases in the rates of missing data on specific Core variables (see image below). In 2014, 73% of the Arkansas' cases had missing data for the variable assessing child's health insurance; two years later, it was only missing in 1% of the cases. Porter is pleased, but still sees room for improvement. Lack of investigations, or challenges accessing records still make it difficult for teams to get all the information they want. She continues to encourage teams to build relationships to break down barriers to effective data collection, recognizing quality data drives effective prevention.

If your state program is interested in ways to improve your data quality, please contact us at info at ncfrp.org<mailto:info at ncfrp.org>; we are happy to help you consider ways to improve fatality review data to drive effective prevention.

National Center releases Improving Racial Equity in Fatality Review

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Fatality review methodologies offer unique strategies for analyses of individual and community factors that significantly affect health disparities, including community members' experiences of racism. Acknowledging this, the National Center released Improving Racial Equity in Fatality Review<http://r20.rs6.net/tn.jsp?f=001lDYOgZQvAGQ_3SeJG0BWFOGRgDhIqMHC0fklef5c43BDj96T57fBOeOHY-JYodYD5alqBJg69iiM3C2HQUSBM8EL4wGyJIn0gtrCNQONNF_GhE9W-JpusqFx5mZnTXuhDuZbh5kx_BJiaHDyJ3iJ9vLJdQNLkV4AA78EShG9BPdsSALm7NtvZaEj_E-zlnFQW1tHxeexhNbRrROOrGwdcEs7O5WLU-Ms&c=6nBKsN837oRlP91hkA5Czk2gP9kNZPqw03YOAXzapPlj9TbsjI3d8Q==&ch=DXgnukiasAado1O12Ll6Qd7foz18Lk_NCa0pRNgMRKr7b2pl3kaUKA==> in August. It is intended to provide guidance for fatality review teams:

*     On team composition and education to new and existing teams to help members understand implicit bias and other equity issues.
*     On gathering the right records to help teams understand mothers'/families' experiences of racism, the impacts of other social determinants of health, and how those experiences may have impacted maternal and child outcomes.
*     On ensuring that--once teams have their findings--they are making and implementing meaningful recommendations that effectively address disparities and the social determinants of health.
*
The National Center is excited to help teams build capacity to address systemic racism and promote health equity through the fatality review process.

National Center promotes video training module series for fatality review

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The National Center is excited to highlight a series of video modules <http://r20.rs6.net/tn.jsp?f=001lDYOgZQvAGQ_3SeJG0BWFOGRgDhIqMHC0fklef5c43BDj96T57fBOSkF7kEQMCceNGTfkn1RX6zGPVT5l0o9KX4PfavF5sibMamUjSX___BYnPwS8Bzys-9PETYctL0N7HNsyPAXGxCCFdURUExXZ-LLUK9gsSm9YC53p7mdB1Bg6DfinjIBXQkdh-ngtpD9AJdlBnxgGqo=&c=6nBKsN837oRlP91hkA5Czk2gP9kNZPqw03YOAXzapPlj9TbsjI3d8Q==&ch=DXgnukiasAado1O12Ll6Qd7foz18Lk_NCa0pRNgMRKr7b2pl3kaUKA==> created to support the work of FIMR and CDR teams. All under one hour in length, the 13 modules are available on the National Center website.<http://r20.rs6.net/tn.jsp?f=001lDYOgZQvAGQ_3SeJG0BWFOGRgDhIqMHC0fklef5c43BDj96T57fBOUjA6aw4gLIlwAC-PyXmxbU8HrIyUK43mtbGFgSOGJEKXiCeg6rXKD3_q_9vjYy8g0vnBWKOdU6cgjT11qJEpAQ=&c=6nBKsN837oRlP91hkA5Czk2gP9kNZPqw03YOAXzapPlj9TbsjI3d8Q==&ch=DXgnukiasAado1O12Ll6Qd7foz18Lk_NCa0pRNgMRKr7b2pl3kaUKA==>

Half of the modules are focused on fatality review process topics such as: CDR 101; FIMR 101; National Fatality Review-Case Reporting System; and Maternal Interviews.
The other half focus on best practice topics such as: Building, Maintaining, and Sustaining FIMR Teams; Collaborating Across Review Systems; and Partnering for Prevention.

The modules were designed to support the work of fatality review teams, leaders, and their partners. They are ideal to include as part of an onboarding process for new coordinators or team members, when rolling out a newly-adopted process such as maternal interviews, or joining the National Fatality Review-Case Reporting System. Click here to access the module series<http://r20.rs6.net/tn.jsp?f=001lDYOgZQvAGQ_3SeJG0BWFOGRgDhIqMHC0fklef5c43BDj96T57fBOSkF7kEQMCceNGTfkn1RX6zGPVT5l0o9KX4PfavF5sibMamUjSX___BYnPwS8Bzys-9PETYctL0N7HNsyPAXGxCCFdURUExXZ-LLUK9gsSm9YC53p7mdB1Bg6DfinjIBXQkdh-ngtpD9AJdlBnxgGqo=&c=6nBKsN837oRlP91hkA5Czk2gP9kNZPqw03YOAXzapPlj9TbsjI3d8Q==&ch=DXgnukiasAado1O12Ll6Qd7foz18Lk_NCa0pRNgMRKr7b2pl3kaUKA==>. Happy viewing!

Violence prevention resource released

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The CDC Division of Violence Prevention released Select, Adapt, Evaluate! How to Use Essential Elements to Inform Your Prevention Approaches<http://r20.rs6.net/tn.jsp?f=001lDYOgZQvAGQ_3SeJG0BWFOGRgDhIqMHC0fklef5c43BDj96T57fBOeOHY-JYodYDW6fWhsusoiq44nM6FVMzKKfPuapwEOVhdAOWYvPbDfDibsHo8BTqyku2qFMz2t9cNrYshRH4u81GB3GFTzFwYf-6BXbPIFU4wL9FaDGz23m57Udu83yPATFoH8cCco-TO8Lor2XG9JA=&c=6nBKsN837oRlP91hkA5Czk2gP9kNZPqw03YOAXzapPlj9TbsjI3d8Q==&ch=DXgnukiasAado1O12Ll6Qd7foz18Lk_NCa0pRNgMRKr7b2pl3kaUKA==> in August. The tool helps state and local partner with the implementation of prevention approaches based on the best available evidence.
Because each community and state is unique, practitioners must decide how to balance the benefits of certain prevention programs with the reality of their local contexts. This tool was developed to support this important decision-making process. Select, Adapt, and Evaluate! explains how evidence-informed approaches work and suggests ways to effectively select, deliver, adapt, and evaluate evidence-based programs, or promising or emerging approaches.

*****CONFIDENTIALITY  NOTICE*****

This e-mail may contain information that is privileged, confidential, or otherwise exempt from disclosure under applicable law. If you are not the addressee or it appears from the context or otherwise that you have received this e-mail in error, please advise me immediately by reply e-mail, keep the contents confidential, and immediately delete the message and any attachments from your system. 

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