Improving Quality and Efficiency in Pediatric Emergency Department Behavioral Health Care

Area of Science:

• Pediatric Emergency Medicine
• Behavioral Health Services
• Quality Improvement Initiatives

Background:

• Emergency departments (EDs) face increasing utilization for pediatric behavioral health concerns, leading to longer stays and higher costs.
• Existing resources are strained by the rising frequency and complexity of these visits.
• A need exists to enhance the quality of care for children with behavioral health crises in the ED.

Purpose of the Study:

• To implement a multidisciplinary initiative aimed at improving care for pediatric patients in the ED.
• To decrease the average length of stay by 10% (from 5.2 hours).
• To increase suicide screening rates to 90% and enhance patient/family experience by 10%.

Main Methods:

• A multidisciplinary team mapped care processes and standardized suicide risk screening.
• Staffing was optimized, and a patient/family informational brochure was developed.
• Dashboards and a post-discharge call-back system were implemented to track post-acute care engagement, using run charts for analysis.

Main Results:

• Overall ED length of stay decreased from 5.2 to 4 hours.
• Patient experience scores improved from 89.7 to 93.2.
• Suicidality screening rates increased from 0% to 94%, with no significant change in the 72-hour return rate.

Conclusions:

• Multidisciplinary team engagement and strategic improvements effectively enhanced care for pediatric behavioral health crises in the ED.
• Key metrics such as length of stay, patient experience, and screening rates showed significant positive changes.
• Reducing patient recidivism remains an ongoing objective for future interventions.