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Download: ED Care Pathway
Understand the path a patient follows when they enter the ED for mental and behavioral health.
PMHCA Technical Assistance Toolkit
This toolkit is for Pediatric Mental Health Care Access (PMHCA) awardees who are seeking to expand their programs into the emergency care space. This toolkit will help teams navigate the process of working with emergency care providers. It also provides guidance on how to apply quality improvement (QI) methods to identify areas of improvement, create implementation plans, and measure change efforts.
The application of QI aims to improve the quality of care for children experiencing mental or behavioral health crises in emergency settings by identifying areas that require attention within the ED setting and implementing necessary changes.
PMHCA teams can ensure they deliver high-quality services by adapting to the specific needs and workflows of the EDs in their communities. This means that they need to be familiar with the specific requirements of the EDs they are working with. EIIC is dedicated to providing expertise in this area to create a positive impact on the collaboration between PMHCAs and their partnering EDs. This partnership aims to address the mental and behavioral health needs of pediatric patients in a more effective manner.
How to use this toolkit
Teams can use this toolkit as a roadmap for identifying opportunities within the ED. It also helps assess a PMHCA team's readiness to engage with EDs and choose a path for the team to pursue. You can work through the toolkit sequentially or view it as a menu of options to choose from.
Before you start, you and your team must answer two questions.
- Do you know where the opportunities are within the EDs you want to work with?
- Does your team have the capacity and capability to fulfill those opportunities?
Goal(s):
- Understand what the ED is already doing.
- Understand what matters most to the ED when addressing pediatric behavioral health.
What to consider:
- EDs continue to be frequent access points for those who suffer from mental health conditions and substance use disorders.
- Many EDs lack the capacity or capability to support these individuals. This lack often leads to prolonged "psychiatric boarding."
- The lack of coordinated care for the patient leads to poor experience and poor health outcomes.
- PMHCA teams are uniquely positioned to work alongside EDs and can provide behavioral health support to providers and staff.
What to do:
- Review an overview of the ED Care Path.
- Review ways PMHCAs can support EDs.
- Review PMHCA Toolkit ED Workflow Engagement Examples.
- Conduct a needs assessment. The needs assessment will help your team identify and focus on the needs of the EDs you collaborate with. This will involve gathering information about their current situation, what processes are in place, and identifying areas of concern or opportunity. The results of your needs assessment will guide your team's decision-making. This will ensure that resources are effectively used to meet the group or organization's needs. Example needs assessment questions can be found here.
Goal(s):
- Understand your team's readiness to expand into EDs in terms of four key areas.
What to consider:
The four areas are capacity and capability, medical-legal and reimbursement, partnerships and collaborations, and technology. Each key area is divided into three sections:
- Team Activity: By addressing these questions, you can create a comprehensive plan that sets realistic expectations.
- Pro-Tips: Tips to help you assess your team's infrastructure and begin to determine your ED expansion work.
- The 4s:
- Stuff: The tools and resources you have available to you.
- Staff: Your current staffing and personnel.
- Space: The spaces you are working within.
- Systems: The policies and procedures in place guiding your work.
What to do:
- Review webpages on the four key areas and follow the steps outlined on each.
Goal(s):
- Identify the organization and methods you will use to guide your work.
What to consider:
- How do you know if your efforts resulted in an improvement? You need information. You need data.
- How will you best capture that information and data?
What to do:
- Review the following information and resources to help support you in implementing your project.
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