The “Who” and the “Who Not”
New approaches to prenatal care focus on identifying low-risk expectant mothers and reducing their average number of in-person clinic visits. A program out of Mayo Clinic defines low-risk patients based on the absence of specific pregnancy risk factors. These low-risk expectant mothers are seen half as often as their higher-risk counterparts and are given resources to monitor their care and access support from their home as opposed to the hospital or clinic. Standard prenatal care includes 12–14 in-office visits during a 40-week pregnancy; but for low-risk expectant mothers, these appointments simply confirm a healthy pregnancy at the price of unnecessary intrusions, office visits, and interventions. Making a distinction between the “who” and the “who not” helps prioritize medical resources for those women who need more attention to ensure a healthy pregnancy.
When it comes to opening a child protection case, the “who” is just as important as the “who not.” Every family involved in a child abuse or neglect incident does not require the same level of child welfare services. Yet in terms of case assignment and resource allocation, many child welfare agencies treat each case the same. This means that services are sometimes provided to families who will not benefit from them, while other high-risk families do not receive the time and attention needed to protect their children. Using the Structured Decision Making®
risk assessment to classify families based on known risk factors for recurrent child abuse or neglect allegations can help a child protection agency distinguish between the “who” and the “who not.” The result is that agencies can allocate resources to those families that will benefit most from such investment.