A Quality Improvement Initiative to Decrease Behavioral Health Unit Readmission Rates.

Area of Science:

• Pediatric Behavioral Health
• Healthcare Quality Improvement
• Inpatient Psychiatry

Background:

• Youth behavioral health inpatient beds are limited, and readmission rates are high, with up to one-third of patients readmitted within a year.
• Over one-third of youth initially admitted for suicidal ideation or attempt are readmitted within 7 days.

Purpose of the Study:

• To decrease 7-day and 30-day readmission rates to a pediatric behavioral health unit (BHU) by 20% by May 2023.

Main Methods:

• Collected baseline data on pediatric BHU readmissions from July 2020 to July 2021.
• Implemented interventions including standardized workflows and checklists using Plan-Do-Study-Act cycles from October 2021 to November 2022.
• Analyzed performance using statistical process control charts and tracked sustainment through December 2023.

Main Results:

• 7-day readmission rates decreased by 49% (from 5.54 to 2.83 per 100 hospitalizations).
• 30-day readmission rates decreased by 36% (from 11.52 to 7.38 per 100 hospitalizations).
• Readmission checklist compliance was high at 97.5%.

Conclusions:

• Adoption of multiple interventions, including standardized workflows and checklists, effectively reduced readmissions to a pediatric BHU.
• These interventions contributed to improved patient outcomes and potentially more efficient use of limited inpatient resources.