P2.168: Improving Identification of Human Trafficking in the Pediatric Emergency Department: A Quality Improvement Project

Purpose/Objectives: Human trafficking is a pervasive public health issue affecting vulnerable populations, including children. In the United States, 9,619 cases of human trafficking were identified in 2023, including 2,535 minors. Nationally, Michigan ranked among the top 10 states, accounting for 2.64% of all identified cases and ranking as the 8th highest state (1). The pediatric emergency department (ED) often serves as a critical access point for healthcare among trafficked youth. Identifying trafficked children remains challenging. At our institution, an average of 10 pediatric patients per year are identified as victims of trafficking; however, this likely represents only a fraction of cases.
Early identification of trafficked youth in the ED can improve access to timely interventions, mitigate ongoing abuse, and connect patients with appropriate resources. This underscores the need for a systematic approach to enhance provider education and implement screening processes tailored to the pediatric ED setting to increase detection rates.
This quality improvement project aims to increase the identification of children at risk for or undergoing trafficking by implementing a structured screening and education program in our pediatric ED. It also seeks to enhance provider confidence and readiness, and establish sustainable practices for trafficking screening in the pediatric ED.
(1) National Human Trafficking Hotline. (n.d.). Statistics. Available from https://humantraffickinghotline.org/en/statistics

Design/Methods: This QI project uses a three-phase approach to improve human trafficking identification in a pediatric ED. Phase 1 assessed staff knowledge and barriers via a pre-intervention survey. Phase 2 introduced tailored training, a clinical guideline, badge cards, and a validated screening tool for nurses and physicians. Phase 3 will evaluate post-intervention changes through a follow-up survey, screening tool usage, and case identification rates. The goal is to enhance detection and response for at-risk pediatric patients.

Results: Quantitative data from pre- and post-surveys will be analyzed to measure changes in staff confidence and knowledge. Screening tool metrics, including completion rates and the number of positive screens, will be tracked to assess the intervention's effectiveness in increasing case identification.
Pre-intervention surveys showed gaps in knowledge, confidence, and resources among pediatric ED staff regarding the identification and management of human trafficking cases. While 68.76% of respondents indicated they were likely to use CPGs, only 26.57% felt confident identifying human trafficking cases, and 32.82% reported low familiarity with existing protocols.

Conclusion/Discussion: This study underscores the urgent need for improved human trafficking identification in the pediatric ED. Moving forward, key steps include expanding our screening model hospital-wide, integrating trafficking screening into residency training to ensure long-term sustainability, and developing an automated EMR alert system to flag at-risk patients. This project represents just the first step toward creating a safer ED environment for vulnerable children, with the ultimate goal of enhancing detection and intervention efforts to protect those at risk.