CPS statement draws attention to need for improved child death review

Alberta Human Services Minister Manmeet Bhullar said in January that the province would change reporting rules and examine options for the review of all child deaths in Alberta. This announcement was made at the province’s Roundtable on Death and Serious Injury in Children.

Dr. Jennifer MacPherson, a Calgary paediatrician, was presenting the CPS statement on child and youth death review during this event; she believes evidence cited in the statement may have had an impact on Alberta’s decision to examine its death review system.

“The statement makes a compelling argument for ... a formal death review system,” said Dr. MacPherson. “It cites other countries and explains that Canada should also be meeting a standard.”

Dr. MacPherson sees Alberta’s commitment as progress, but hopes other provinces and territories follow suit, and that Canada eventually has a nationwide standardized system.

Unintentional injuries are the leading cause of death in Canadian children and youth, but only a few provinces have formal child death review systems. Each is independent and operates differently, limiting how much regions can learn from one another. More importantly, lack of standardized data makes it difficult to implement effective prevention and intervention strategies.

“With no systematic review, it’s just a shot in the dark,” said Dr. MacPherson. “With a mandate and data easily available, systematic review is a tool for prevention.”

The CPS statement calls for a formal, standardized child death review system for every region in Canada to fill this information void. Recommendations include:

• Broad representation including: a regional chief medical examiner or coroner; representatives from law enforcement, child protective services, local public health; a crown attorney; a paediatrician, family physician and/or other health care provider.
• Structured processes for reporting trends.
• Linkable databases to allow meaningful data collection.
• A mechanism to report effectiveness of child death review follow-up and recommendations.
• Designated financial support by all levels of government.

Dr. Natalie Yanchar, co-author of the statement, envisions a nationwide system that would allow stakeholders from multiple disciplines and agencies to share information and learn from each other. This process would ideally lead to policies that prevent deaths and improve the overall health and safety of children and youth.

“We want to compare what’s going on across the country, but more importantly, learn from each other to see what  works—[and] we can’t,” said Dr. Yanchar. “[With a standardized, national system], you’re going to be looking at the underlying causes. You can then identify the causes,...determine the intervention and bring in the intervention that will reduce the risk.”

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