Keeping Kids Alive in Wisconsin
No greater tragedy exists than the loss of a child; an event that often can be prevented. Each year, more than 600 deaths occur to children under age 18 in Wisconsin. Over one-quarter of these deaths are due to injury. Child death review (CDR) teams are multidisciplinary groups of experts charged with determining all risk factors and circumstances leading to the child’s death in an effort to generate recommendations for preventing future deaths. In 2008, Keeping Kids Alive in Wisconsin received a three-year implementation grant from the University of Wisconsin Partnership Program to begin building a sustainable CDR program in each of Wisconsin’s 72 counties. Grant partners include Children’s Health Alliance of Wisconsin, Wisconsin Department of Justice, Wisconsin Department of Health Services and the Injury Research Center at the Medical College of Wisconsin.
Keeping Kids Alive in Wisconsin had three objectives:
The first objective was to provide assistance to 30 Wisconsin counties to develop CDR teams. Over the course of the grant, 39 CDR teams were created or restructured, while an additional 14 counties expressed interest in implementation.
The second objective was to facilitate data collection and participation in the National Case Reporting System for Child Death Review. Over 70% of teams entered data into the system.
The final objective of the project was to develop recommendations and establish governing policy and sustainability for implementation by state leaders for a model CDR system in Wisconsin. To address implementation barriers reported by local teams, partners created a legislative framework to enable formation of local CDR teams. This framework is currently at the Legislative Reference Bureau for drafting.
The Injury Research Center was instrumental in achieving all three objectives by developing webinars and training tools to facilitate data entry and improve data quality, as well as working with local teams in using data to create recommendations for prevention. The grant allowed partners to build a comprehensive CDR program that enabled local communities to learn from child deaths and use meaningful data as a catalyst for prevention.
One issue that emerged at both the national and state levels during the grant period was infant safe sleep. Over half of child deaths in Wisconsin occur in those aged less than one year. Of those infant deaths in the Case Reporting System, one-third were classified as “sleep-related”. Fetal Infant Mortality Review (FIMR) is a review process which focuses on infant and stillbirth deaths. Like CDR, FIMR teams review risk factors and circumstances surrounding the infant death in order to prevent future deaths. In 2011, the partners convened with the Milwaukee County Fetal Infant Mortality Review Team leadership to develop Preserving Infant and Child Health. The goal of this project was to build upon the success of Keeping Kids Alive and reduce the burden of infant and child mortality utilizing both the FIMR and CDR processes in five pilot counties across the state. FIMR and CDR currently exist as two separate review systems, lacking formal collaboration and communication. The combined use of FIMR and CDR in counties could have a greater chance for improving health outcomes for problems like unsafe sleep environment deaths. The partners received three years of funding to implement Preserving Infant and Child Health from the University of Wisconsin Partnership Program in 2012.