Over the last decade, pediatric mental health emergency department (ED) visits and hospitalizations have risen substantially.1,2 Increasingly, children experience boarding in the ED and inpatient medical units while awaiting inpatient psychiatric beds.3,4 To address this evolving crisis, quality improvement (QI) can be leveraged to improve outcomes by effecting local change. This issue of Pediatrics reports 2 successful QI initiatives that improved acute pediatric mental health services using different interventions to address distinct targets. These reports offer valuable lessons regarding both strengths and limitations of QI, relative to alternative approaches.
Afzal et al5 implemented a boarding stabilization protocol in an ED observation unit, centered around brief interventions delivered by social workers and activities provided by child life specialists. After implementation, inpatient psychiatric admissions decreased from 66% to 49%. Because the boarding stabilization protocol relied on increased personnel support, it may be difficult to translate...
Comments