Table 1 Child Abuse Framework of the Dutch Health Care Inspectorate October 2008: all criteria were required to be in place by January 2009

  1.

There is policy at the level of the Board of Directors to address child abuse; this policy is documented and funding for this policy is secured.

  2.

There is policy within the hospital for dealing with suspected child abuse in the ED. This policy is documented and compliance with policy is checked.

B. Child abuse team, special child abuse attendant, cooperation with Child Abuse Center

  3.

A child abuse team is in place. The purpose, duties and procedures of this team are documented. The team has representatives from the ED, a pediatrician, a child psychologist, a social worker and a surgeon; the team meets at least twice a year.

  4.

The hospital has a special child abuse attendant who has a job description, and was consulted at least 1–10 times in the first half of 2007. Functionality is ensured by provision of sufficient hours and budget.

  5.

Structured consultations take place with the Child Abuse Center; a pediatrician and an ED staff member is present at these consultations. The cooperation is evaluated for procedure and content.

C. Protocol for suspected child abuse

  6.

The hospital has a hospital-wide protocol, as well as a protocol in the ED for dealing with signs/suspicions of child abuse. The SPUTOVAMO* checklist and its manual are part of the ED protocol.

D. Professional development

  7.

The hospital has a training program for the detection of child abuse. This program is well structured and documented; 95-100% of the ED staff follow the program.

E. Registry and information

  8.

It is known how many children visited the ED. The SPUTOVAMO* checklist is used for all (100%) children. These numbers are recorded.

  9.

It is known how many children were suspected of child abuse based on the SPUTOVAMO* checklist; these numbers are recorded. A member of staff is available to perform and control these registrations.

  10.

For all children who visited the ED in the first half of 2007, it is known how many times the Child Abuse Center was consulted. These numbers are recorded, and for at least 50% of the children of suspected child abuse the Child Abuse Center was consulted.

  11.

For all children who visited the ED in the first half of 2007, it is known for how many a referral or report was made to the Child Abuse Center or to other types of aid; these numbers are recorded. Someone is available for implementation and management of this registration.