Behavioral Health Issues Clinical Pathway — Emergency Department

Goals

  • Increase staff confidence and competence around identifying and assessing children at risk for or presenting with agitation or suicide concerns in the ED.
  • Guide staff communication strategies regarding agitated children.
  • Decrease restraint events and employ de-escalation strategies using least-restrictive interventions first and a trauma-informed approach.
  • Reduce length of time using restraints.
  • Update patient care plan with effective strategies.
  • Reduce child and staff injuries associated with behavior events.
  • Reduce ED LOS for children that require behavioral health evaluation by using a team-based approach and consulting Social Work and/or Psychiatry at the time of child's arrival.

Metrics

  • % children with ASQ administered at triage.
  • % of ASQ High-risk children with CHOP Observer initiated.
  • Number of KAPS reports related to a behavioral health crisis.
  • Number of violent restraint events in ED.
  • Number of medications used for de-escalation.
  • ED LOS for children admitted to inpatient psychiatric unit.
  • ED LOS for children discharged.
  • Number and percentage of children with behavioral health issues admitted to the medical unit due to unavailable inpatient psychiatric beds.
  • Number of children that received Safety Observation.
  • Return visits to the ED.