Clinical Fellow Johns Hopkins Children's Center Johns Hopkins University Baltimore, Maryland, United States
Background: Mental health crises are commonly treated in the pediatric emergency department (PED) and often require admission. Inpatient psychiatric shortages may lead to patients boarding in the PED pending admission. There is a lack of research exploring patients’ mental health symptoms during and personal reaction to this boarding experience.
Objective: Our objective was to assess the self-reported patient experience of boarding in the PED pending mental health admission. We aimed to evaluate the effect on symptoms, communication with staff, family involvement, and satisfaction of activities/ interventions already utilized in our PED.
Design/Methods: A convenience sample interview was conducted from 2/2020-11/2020. Sampling paused from 4/2020-7/2020 for Covid-19 research restrictions. Inclusion criteria was: PED boarding beyond 24 hours for a mental health condition requiring social work evaluation. Exclusion criteria was inability to participate in the survey, such as patients who were: non-verbal, combative, with psychosis, with intellectual disability, and boarding for Child Protective Services purposes. If patients became upset by the interview, it was concluded. Interviews were led by 3 researchers and participants received a gift card. Statistical analysis was completed via chi-squared testing.
Results: 41 patients met inclusion criteria and agreed to participate. Patients who enjoyed mental health specialist meetings noted these being overall helpful (31.8%), providing advice (27.3%), kind interactions (27.3%), hearing updates (18.2%), and addressing active symptoms (18.2%). Patients reported 9 categories of helpful resources already provided in our PED, most commonly activities (85.4%), novels (26.8%), electronics (22%), and stress balls (14.6%). 9 categories of resources were identified that patients would like to include in their care plan, notably electronics (29.3%), staff/ therapy time (24.3%), age-appropriate daily schedule (17.1%), physical activity with time outside (12.2%), improved PED environment (9.8%), and less time waiting for placement (9.8%). Some noted more than one of the above as beneficial. Conclusion(s): While patients reported some helpful interventions and supportive staff in the PED, many experienced worsening anxiety while boarding. Patients were equivocal on wanting more social work meetings; research is needed to determine which type of therapy would be most efficacious and well-received. Next steps include discussions to implement patient-recommended activities for our boarding population.
Self-Reported Patient Experience While Boarding for Mental Health Care
Authors/Institutions: Julianne Lapsa, Johns Hopkins University, Baltimore, Maryland, United States; Erin O'Donnell, Johns Hopkins University, Baltimore, Maryland, United States; Leticia M. Ryan, Johns Hopkins University, Baltimore, Maryland, United States; Thuy L. Ngo, Johns Hopkins University, Baltimore, Maryland, United States