Effects of Having a Pediatric Psychiatrist in the ED & creation of a Bridge Clinic

Author(s)

Abstract
Objective: The rates of pediatric psychiatric patients who present to the Emergency Department (ED) have increased by 20% in the past ten years. There has been limited investigation into addressing this surge. This retrospective Quality Improvement (QI) study evaluates the impact of creating two programs within this Healthcare system to address the pediatric ED mental health patient surge and boarding crisis. The first intervention was having a pediatric psychiatry consult service (PPCS) to the ED and the second was creating a bridge clinic.
Methods: Psychiatry patients in the ED were seen consistently by the PAAT throughout the study. Measurements were performed one year prior to (n=853) and after (n= 825) the addition of a PPCS to the ED. An analysis of the PPCS for changes in ED length of stay (LOS); and % discharged to home was done. Additionally, we assessed Bridge Clinic patients for a year period for variation in their number of ED visits pre-vs. post-initial bridge clinic encounters.
Results: Comparison of 2017-2018 vs. 2018-2019 yielded a 7% increase in discharges (p=0.004). Mean ED LOS decreased by 45 minutes (p=0.315). When comparing patients' three months pre- versus post-initial bridge clinic encounters (n=96), the average ED visits decreased by 0.93±0.16 (95% CI; p < .001).
Conclusion: After incorporation of PPCS, the percentage of discharges significantly increased, and ED LOS decreased. Patients in the Bridge clinic had a reduced ED presentation post intervention. We are hopeful that further implementation and resource allocation will improve the effectiveness of such services

Keywords
bridge clinic, emergency medicine, transitions clinic

Cite this paper
Mbu, Petronella, Rea Deirdra, Effects of Having a Pediatric Psychiatrist in the ED & creation of a Bridge Clinic , SCIREA Journal of Clinical Medicine. Volume 6, Issue 6, December 2021 | PP. 500-514. 10.54647/cm32656

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