Enhancing the Safety of Children in Foster Care and Family Support Programs: Automated Critical Incident Reporting
Brenner, Eliot, Freundlich, Madelyn, Child Welfare
The Adoption and Safe Families Act of 1997 has made child safety an explicit focus in child welfare. The authors describe an automated critical incident reporting program designed for use in foster care and family-support programs. The program, which is based in Lotus Notes and uses e-mail to route incident reports from direct service staff to supervisors and administrators, facilitates timely clinical oversight and risk management and ensures the security of clients' protected health information. The authors present data collected using the program to illustrate how it can be used to monitor abuse and neglect allegations in a foster care program. A survey of users found that the program saved time, was easy to use, and helped manage critical incident reports.
The Adoption and Safe Families Act in 1997 has made child safety a more explicit focus in child welfare. Policy and practice now place a greater emphasis on assessing the effectiveness of child protective services in responding to reports of child maltreatment and on ensuring the safety of children in foster care (Fitzgerald, Bailey, & Litton, 2003). Although protecting children in foster care has been an issue of concern, researchers have collected little data about the scope of this problem or the specific situations that compromise children's safety while in outof-home care. The federal Child and Family Service Reviews have improved data collection on this issue to some extent (Administration for Children and Families, 2003).
The literature, however, addressing how child welfare agencies should monitor and ensure the safety and well-being of children in foster care continues to be extremely limited. In particular, little attention has been given to the role of critical incident reporting in monitoring and ensuring positive outcomes related to children's safety while in foster care. The absence of attention to this issue is surprising, given the requirements of the Council on Accreditation, which accredits more than 1,400 social service and behavioral health organizations that monitor and address incidents, accidents, and grievances (Council on Accreditation, 2004).
This article describes an automated critical incident reporting system casey Family Services has developed and implemented. casey Family Services, the direct service arm of the Annie E. casey Foundation, is a multiservice child welfare agency based in New Haven, Connecticut, which provides foster care and other child welfare services through 15 offices in the six New England states and Baltimore, Maryland. casey developed its critical incident reporting system to respond to and effectively address the safety of children in foster care and family support programs, as well as to promote the well-being and permanency of children under the agency's care. This article reviews the very limited literature in the area of critical incident reporting; discusses the importance of automating critical incident reporting; describes the casey system; presents survey data suggesting that the system is user-friendly, saves time, and helps staff manage incident reports; and discusses how the agency uses data from the automated system to improve services and outcomes for the children in its care.
The literature on continuous quality improvement identifies the safety of the service environment as a key category of program quality (Brown, 2001), and it makes clear that mechanisms are needed to evaluate the safety of clients and develop appropriate responses when their safety is compromised (Gambrill & Shlonsky, 2001; Pecora, seeling, Zirps, & Davis, 1996). Nonetheless, the literature that addresses these mechanisms in child welfare in general and critical incident reporting in particular has been limited. To the extent that the literature has described the use of critical incident reporting, the principal focus has not been on the safety of children in foster care, but on such issues as infant abduction (Rabun, 1996) and personal risks to social workers (Griffin, 1995). …