Every child, every time: hospital-wide child abuse screening increases awareness and state reporting Abstract Purpose A review of our child abuse evaluation system demonstrated a lack of standardization leading to low reporting levels. The purpose of this quality improvement initiative was to develop a standard child abuse screening tool; an education program increasing awareness to child abuse; and to measure the impact of the screening tool in reporting. Methods A screening tool was developed and implemented for all trauma patients < 15 years of age; staff was educated; and a child protection team (CPT) was established. Within 9 months, screening was extended to all patients admitted to the children’s hospital. Screening compliance, number of child abuse reporting forms (CY-47) filed, and consultations to the CPT were monitored. Results Initially, there was an average screening compliance of 56%. After making the program hospital-wide, the compliance rate increased to an average of 96%; and the average number of CPT consults increased from 2 to 10 per month. Over this study period, the average number of CY-47s filed increased from 6.1 to 7.3 per month. Conclusions Hospital-wide use of an objective screening tool, frequent re-education, and the support of an experienced child protection team led to improved child abuse screening compliance and more consistent suspected-abuse reporting rates.