The seven pillars of quality care in a statewide pediatric sexual assault nurse examiner program.

This article describes a systematic approach used by a statewide pediatric sexual assault nurse examiner program to ensure the quality of forensic medical examinations it provides in child sexual abuse investigations. Seven strategies for enhancing quality are described: (a) hiring experienced professionals, (b) effective training, (c) comprehensive protocols, (d) ample support for pediatric sexual assault nurses, (e) management oversight, (f) a clinical coordinator to provide ongoing training and technical assistance, and (g) a quality assurance process in which expert child abuse pediatricians review each statewide pediatric sexual assault nurse examination. To show the evolution of quality care over time, the program's experience from 2004 to 2010 is reviewed, and quality assurance data are analyzed.