A Collaborative Behavioral Model for Psychiatric Visits in a Pediatric Emergency Department

Kelsey Caffy, Tamekia Jones, Barry G. Gilmore

Research output: Contribution to journalArticle

Abstract

Objectives Psychiatric pediatric emergency department (PED) visits are associated with extended length of stay (LOS) compared with nonpsychiatric visits. To address delays in definitive care, our PED incorporated a Collaborative Behavioral Model for patients with a psychiatric complaint. We evaluated LOS and 6-month readmission by comparing patients who received a psychiatric consultation through the model with a control group of nonpsychiatric patients. In addition, we assessed the utilization of laboratory tests and imaging and the impact of testing on final patient disposition. Methods A matched-pair retrospective chart review of psychiatric PED visits was conducted for visits from January 1, 2009, to December 31, 2013. Patients who received a psychiatric diagnosis and consultation through the Collaborative Behavioral Model were included. Participants were matched with a control group of similar patients who did not receive a psychiatric diagnosis. Results One hundred forty-seven patients met all the inclusion criteria. There was no statistical difference in median LOS for patients who received a psychiatric consultation versus nonpsychiatric visits (204 vs 200 minutes; P = 0.35). The 6-month PED readmission rate for psychiatric visits was significantly less than that in the control group (18% vs 32%; P = 0.003). Of the laboratory and imaging studies performed, 1 abnormal laboratory test (1%) and no imaging studies resulted in a change in patient management. Conclusions Collaborative models, with specialized psychiatric components, can better coordinate the care of mental health visits by providing focused interventions that promote efficient disposition. In addition, laboratory and imaging studies resulted in few changes in management or final disposition.

Original languageEnglish (US)
Pages (from-to)461-467
Number of pages7
JournalPediatric Emergency Care
Volume35
Issue number7
DOIs
StatePublished - Jul 1 2019

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Psychiatry
Hospital Emergency Service
Pediatrics
Length of Stay
Referral and Consultation
Mental Disorders
Control Groups
Patient Readmission
Mental Health

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

Cite this

A Collaborative Behavioral Model for Psychiatric Visits in a Pediatric Emergency Department. / Caffy, Kelsey; Jones, Tamekia; Gilmore, Barry G.

In: Pediatric Emergency Care, Vol. 35, No. 7, 01.07.2019, p. 461-467.

Research output: Contribution to journalArticle

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