Table 2.
Characteristics of the Rapid Response (RR) and Child Death Overview (CDO), arranged according to the Child Death Review objective, and organizations that have these characteristics as a major or minor focus. (a,b,c,d) refer to the documents available for analysis mentioned in Table 1
| Organizations with procedures with | |||
|---|---|---|---|
| Major focus (+ in the appendix) | Minor focus(± in the appendix) | ||
| A | |||
| Objective ‘Improve the quality of the procedure with regard to the determination of the cause of death as well as the death statistics’ | |||
| RR | Rapid response actions exist in cases of unexplained death | Dept. of Pediatrics (a), GP, Forensic Med. Service (a), Cot Death Found. | Child Welfare Agency, Child Protection Service, Publ. Prosecutor, National Cot Death Study Group |
| It has been defined who will lead the investigation to determine the cause of death | Forensic Med. Service (a), Mental Health Services (b), Mental Health Trust (b,c,d), Child Protection Service, Police, Publ. Prosecutor, Perined, National Cot Death Study Group, Cot Death Found. | Dept. of Pediatrics (a), GP, Social Work in hosp. | |
| It has been defined which professionals have to be involved in the investigation to determine the cause of death | Dept. of Pediatrics (a), GP, Forensic Med. Service (a), Mental Health Trust (b,c,d), Child Protection Service, Police, Publ. Prosecutor, Perined, Cot Death Found. | Forensic Med. Service (b), Ambulance Service, Mental Health Trust (a), Child Welfare Agency, Cot Death Comm. | |
| It has been defined what has to be investigated. This includes: data collection from relevant institutions and professionals, postmortem investigation and investigation at the place of death and circumstances of the death | Dept. of Pediatrics (a), GP, National Cot Death Study Group | Dept. of Pediatrics (e), Forensic Med. Service (a,b), Mental Health Trust (b,c,d), Child Protection Service, Police, Publ. Prosecutor | |
| Results are collected and represented according to national criteria | Dept. of Pediatrics (a), GP, Child Protection Service, Police, Publ. Prosecutor, Perined | Forensic Med. Service (a), Mental Health Trust (b,c,d), Cot Death Found. | |
| It has been defined how the relationship between physicians and the forensic physician could be constituted | Forensic Med. Service (a) | Cot Death Found. | |
| It has been defined how often and when the involved professionals have to discuss the results of the investigation to determine the cause of death | Forensic Med. Service (a), Police, Publ. Prosecutor | Dept. of Pediatrics (a), GP, Forensic Med. Service (b), Munic. Health Services (b), National Cot Death Study Group | |
| Relevant institutions and professionals, such as school and GP, are consulted to get relevant information about the possible cause of death | Child Protection Service, Police, Publ. Prosecutor, National Cot Death Study Group | Forensic Med. Service (b), Munic. Health Services (b) | |
| CDO | The results of the review are passed on to a national institution | Dept. of Pediatrics (a), GP, Mental Health Trust (b,c,d), Perined, National Cot Death Study Group | Child Protection Service, Publ. Prosecutor, Cot Death Found. |
| A format to get specific data about a particular cause of death is used | Dept. of Pediatrics (a), GP, National Cot Death Study Group | Perined, Cot Death Found. | |
| The actions of professionals involved in determining the cause of death are analyzed | - | - | |
| Feedback is given to professionals on their actions in determining the cause of death | - | - | |
| New relevant information regarding the cause of death and factors contributing to the death, which is obtained in the long run, is provided to all professionals involved in the death | Child Protection Service, Publ. Prosecutor, Perined | Police, Cot Death Found. | |
| Objective ‘Identify avoidable factors that give directions for prevention’ | |||
| RR | Relevant institutions and professionals, such as school and GP, are consulted to get more information about the child, his/her social circumstances and environment in the context of avoidable factors of child mortality | Child Protection Service, Cot Death Found., Safety Board | Forensic Med. Service (b), Munic. Health Services (b), Publ. Prosecutor, Perined, National Cot Death Study Group, Consumer Safety Inst. |
| During data collection from relevant institutions and professionals, postmortem examination and investigation at the place of death and circumstances of the death, attention is paid to (new) avoidable factors of child mortality | Dept. of Pediatrics (a), GP, Child Protection Service, Cot Death Found. | Publ. Prosecutor, National Cot Death Study Group | |
| CDO | Avoidable factors of child mortality and lessons learned are identified | Dept. of Pediatrics (a), GP, Child Protection Service, Perined, National Cot Death Study Group, Cot Death Found. | Mental Health Trust (a), Police, Publ. Prosecutor, Safety First Assoc., Consumer Safety Inst., Safety Board |
| A distinction is made in factors intrinsic to the child, family and environmental factors, parenting capacity, and service provision | - | Child Protection Service, Perined, Consumer Safety Inst., Safety Board | |
| Professionals involved work together with regional and national institutions to identify lessons learned | Dept. of Pediatrics (a), GP, Child Protection Service, Perined, National Cot Death Study Group, Cot Death Found. | Social Work in Hosp., Publ. Prosecutor, Safety First Assoc., Consumer Safety Inst., Safety Board | |
| After identifying avoidable factors of child mortality, the extent of the problem is determined and (groups of) people most affected by the problem are sorted out | Perined, National Cot Death Study Group, Cot Death Found., Safety Board | Child Protection Service, Publ. Prosecutor, Safety First Assoc., Consumer Safety Inst. | |
| B | |||
| Objective ‘Translate the results into possible interventions’ | |||
| RR | Information relevant for immediate prevention (e.g., protection of other children in the family) is discussed by the rapid response team | Munic.Health Services (b), Mental Health Trust (b,c), Child Welfare Agency, Child Protection Service | Ambulance Service, Police |
| It has been defined which immediate preventive measures have to be taken, when necessary | Mental Health Trust (b,c), Child Protection Service | Child Welfare Agency | |
| CDO | Research ends with a discussion how such a death can be avoided in the future | Perined, National Cot Death Study Group, Cot Death Found. | Mental Health Trust (b,c), Child Protection Service, Safety Board |
| Recommendations, actions to be performed and lessons learned are passed on to relevant authorities or individuals | Mental Health Trust (b,c), Child Protection Service, Perined, National Cot Death Study Group, Cot Death Found., Safety First Found., Consumer Safety Inst., Safety Board | Munic. Health Services (b), Mental Health Trust (a,d), Publ. Prosecutor | |
| Recommendations, actions to be performed and lessons learned are passed on to governmental institutions to improve Publ. health | National Cot Death Study Group, Cot Death Found., Safety First Found., Consumer Safety Inst., Safety Board | Child Protection Service, Publ. Prosecutor, Perined | |
| It has been defined who is responsible for (taking care of) carrying out the improvements | Perined, Safety First Found., Consumer Safety Inst., Safety Board | Mental Health Trust (b,c) | |
| Objective ‘Support to the family’ | |||
| RR | The potential needs of relatives are identified | Dept. of Pediatrics (b,d), Preventive Child Healthcare, Munic. Health Services (a,b,), Social Work in Hosp., Child Welfare Agency, School | Dept. of Pediatrics (a,c), GP, Mental Health Trust (b,c), Publ. Prosecutor, National Cot Death Study Group, Cot Death Found. |
| When a child died in the hospital, parents are supported by a designated professional of the hospital | Dept. of Pediatrics (b), social work in hosp. | Dept. of Pediatrics (d), Munic. Health Services (b) | |
| When conditions permit, parents get the opportunity to be alone with their deceased child to take leave of their child | Dept. of Pediatrics (b,d) | ||
| Parents are informed about up-to-date findings of the research, unless this obstructs the research | Dept. of Pediatrics (a), GP, Munic. Health Services (b), Police | Dept. of Pediatrics (d), Mental Health Trust (b,c) | |
| It has been defined how to act when parents and the deceased child do not live in the same country | - | - | |
| After completion of the rapid response, further (psychological) assistance is rendered to the relatives | Dept. of Pediatrics (b), Preventive Child Healthcare, Munic. Health Services (a,b), Social Work in Hosp., Mental Health Trust (a,b,c,d), Cot Death Found. | Child Welfare Agency, School | |
| CDO | The actions of professionals in supporting grief counseling to relatives are analyzed | Dept. of Pediatrics (b), Munic. Health Services (b) | Social Work in Hosp., Mental Health Trust (a) |
| Relatives are kept in touch in the long run, whereby feedback is given on research of (factors contributed to) the death and grief counseling | Dept. of Pediatrics (b), Munic. Health Services (b), National Cot Death Study Group, Cot Death Found. | Dept. of Pediatrics (a), GP, Preventive Child Healthcare, Munic. Health Services (b), Social Work in Hosp., Child Protection Service, School, Perined | |
| The given support to relatives is monitored | Preventive Child Healthcare, Munic. Health Services (a,b), social work in hosp. | Dept. of Pediatrics (c), Mental Health Trust (a), Cot Death Found. | |
Dept. department, GP general practitioner, Med. medical, Found. foundation, Publ. public, Hosp. hospital, Munic. municipal, Inst. institute, Assoc. association