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Tytuł pozycji:

Improving Mental Health Communication From the Pediatric Emergency Department to Primary Care.

Tytuł :
Improving Mental Health Communication From the Pediatric Emergency Department to Primary Care.
Autorzy :
Esposito JM; From the *Division of Pediatric Emergency Medicine, Children's Hospital of Philadelphia †Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Fein JA
Marshall J
Mitchell C
Aredas B
Zorc JJ
Pokaż więcej
Źródło :
Pediatric emergency care [Pediatr Emerg Care] 2020 Sep; Vol. 36 (9), pp. 424-429.
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Baltimore, Md. : Williams & Wilkins, [c1985-
MeSH Terms :
Communication*
Electronic Health Records*
Emergency Service, Hospital*
Mental Health*
Patient Discharge Summaries*
Primary Health Care*
Adolescent ; Aftercare ; Depression/diagnosis ; Documentation ; Humans ; Inservice Training ; Mass Screening ; Quality Improvement ; Suicide/prevention & control ; Young Adult
Entry Date(s) :
Date Created: 20200902 Date Completed: 20201005 Latest Revision: 20201005
Update Code :
20201023
DOI :
10.1097/PEC.0000000000001928
PMID :
32870615
Czasopismo naukowe
Objectives: Suicide is a leading cause of adolescent death, and emergency department (ED) visits are recognized as an opportunity to identify at-risk youth. For patients screening positive for mental health concerns, we implemented a quality improvement initiative to enhance documentation of results and interventions in the ED, increase communication between the ED and primary care providers (PCPs), and increase PCP follow-up.
Methods: Interventions included education, feedback, and an alert in our electronic health record. Completion of a Behavioral Health Screen (BHS-ED) initiates an alert that reminds ED providers how to document and communicate results and needed follow-up to the PCP. We reviewed a random monthly sample of ED charts for adolescents 14 to 19 years old presenting with nonpsychiatric complaints who screened positive for severe depression or suicidality. Outcome measures included documentation of BHS-ED results in the ED note, communication of positive results to the PCP, PCP follow-up of results, and ED return visits.
Results: Documentation of BHS-ED results increased from 73% at baseline to 88% of patients after the intervention. For patients discharged from the ED with nonpsychiatric chief complaints, communication to PCPs increased from 1% at baseline to 40% during the final 3 months of the study. When PCP communication occurred, 67% of in-network PCPs followed up with patients versus 5% when no communication took place from the ED.
Conclusions: A multifaceted intervention including education and an electronic health record alert improved ED documentation, communication, and PCP follow-up of issues identified during ED-based mental health screens.

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