Christopher Stewart
Affiliate, Peds/Hospital Medicine
Bio
Christopher C. Stewart, MD, FAAP, is a Professor of Pediatrics at UCSF, and board certified in child abuse pediatrics. Dr. Stewart received his BA from Yale, his MD degree from Harvard University and completed his residency training in pediatrics at UCSF. He is a pediatric hospitalist at San Francisco's only trauma center, is director of the Stanford/LPCH, and UCSF Mission Bay Children’s Hospital Suspected Child Abuse and Neglect (SCAN) Teams. Dr. Stewart consults on child abuse cases for several Bay Area County hospitals, as well as consultation and testifying for Child Protective Services and District Attorney’s offices. Dr. Stewart co-directs a child abuse rotation for medical students, residents and fellows at Stanford/LPCH and UCSF. As community service, he co-directs the Child Death Review Team for San Francisco County, and sits on numerous regional county committees and CBOs related to child abuse and neglect. He is a member of the Ray Helfer Society, an honorary society of physicians seeking to provide leadership to enhance the prevention, diagnosis, and treatment of child abuse and neglect. Dr. Stewart has also been PI on several federally and state funded international research training grants. Dr. Stewart has been involved in many international projects, for which he was awarded the UCSF Chancellor’s Award for public service, has received a number of teaching awards, and has provided lectures and training in international settings, including training in the Eastern Democratic Republic of Congo and recently to Syrian doctors documenting torture cases.
Professional Education
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BA, Yale University, Asian Studies (1985)
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MD, Harvard Medical School (1996)
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Pediatric Residency, UCSF, Pediatrics (1999)
All Publications
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SCAN for Abuse: Electronic Health Record-Based Universal Child Abuse Screening.
Journal of pediatric surgery
2023
Abstract
Identification of physical abuse at the point of care without a systematic approach remains inherently subjective and prone to judgement error. This study examines the implementation of an electronic health record (EHR)-based universal child injury screen (CIS) to improve detection rates of child abuse.CIS was implemented in the EHR admission documentation for all patients age 5 or younger at a single medical center, with the following questions. 1) "Is this patient an injured/trauma patient?" 2) "If this is a trauma/injured patient, where did the injury occur?" A "Yes" response to Question 1 would alert a team of child abuse pediatricians and social workers to determine if a patient required formal child abuse clinical evaluation. Patients who received positive CIS responses, formal child abuse work-up, and/or reports to Child Protective Services (CPS) were reviewed for analysis. CPS rates from historical controls (2017-2018) were compared to post-implementation rates (2019-2021).Between 2019 and 2021, 14,150 patients were screened with CIS. 286 (2.0 %) patients screened received positive CIS responses. 166 (58.0 %) of these patients with positive CIS responses would not have otherwise been identified for child abuse evaluation by their treating teams. 18 (10.8 %) of the patients identified by the CIS and not by the treating team were later reported to CPS. Facility CPS reporting rates for physical abuse were 1.2 per 1000 admitted children age 5 or younger (pre-intervention) versus 4.2 per 1000 (post-intervention).Introduction of CIS led to increased detection suspected child abuse among children age 5 or younger.Level II.Study of Diagnostic Test.
View details for DOI 10.1016/j.jpedsurg.2023.10.025
View details for PubMedID 37953157