Detecting child abuse based on parental characteristics: Does The Hague Protocol cause parents to avoid the Emergency Department?

• We evaluated the experience of parents with the Hague Protocol; detecting child abuse based on parental characteristics at the ED.
• We evaluated whether detecting child abuse based on parental characteristics (Hague Protocol) will lead to parents avoiding the ED.
• Implementing a protocol to detect child abuse based on parental characteristics (Hague Protocol) does not lead to parents avoiding medical care.

ObjectivesThe Hague Protocol is used by professionals at the adult Emergency Departments (ED) in The Netherlands to detect child abuse based on three parental characteristics: (1) domestic violence, (2) substance abuse or (3) suicide attempt or self-harm. After detection, a referral is made to the Reporting Center for Child Abuse and Neglect (RCCAN). This study investigates whether implementing this Protocol will lead parents to avoid medical care.MethodWe compared the number of patients (for whom the Protocol applied) who attended the ED prior to implementation with those attending after implementation. We conducted telephone interviews (n = 14) with parents whose children were referred to the RCCAN to investigate their experience with the procedure.ResultsWe found no decline in the number of patients, included in the Protocol, visiting the ED during the 4 year implementation period (2008–2011). Most parents (n = 10 of the 14 interviewed) were positive and stated that they would, if necessary, re-attend the ED with the same complaints in the future.ConclusionED nurses and doctors referring children based on parental characteristics do not have to fear losing these families as patients.