Journal article
Feasibility and Effects of a Web-Based Adolescent Psychiatric Assessment Administered by Clinical Staff in the Pediatric Emergency Department
Archives of pediatrics & adolescent medicine, Vol.164(12), pp.1112-1117
01 Dec 2010
PMID: 21135339
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objectives: To determine the adoption rate of the Web-based Behavioral Health Screening-Emergency Department (BHS-ED) system during routine clinical practice in a pediatric ED, and to assess this system's effect on identification and assessment of psychiatric problems.
Design: Descriptive design to evaluate the feasibility of a clinical innovation.
Setting: The ED of an urban tertiary care children's hospital.
Participants: Adolescents from 14 to 18 years of age, without acute or critical injuries or illness, presenting with nonpsychiatric symptoms.
Intervention: The ED clinical staff initiated the use of the BHS-ED system, which identifies and assesses adolescents for depression, suicidal ideation, posttraumatic stress, substance use, and exposure to violence. Treating clinicians reviewed results and followed routine care practices thereafter.
Main Outcome Measures: Adoption rate of the BHS-ED system by nursing staff, identification rates of occult psychiatric problems, and social worker or psychiatrist assessment. Data were collected for 19 months before implementation of the BHS-ED system and for 9 months during implementation.
Results: Of 3979 eligible patients, 1327 (33.4%) were asked by clinical staff to get screened using the BHS-ED; of these 1327 patients, 857 (64.6%) completed the screening and 470 (35.4%) refused. During implementation, identification of adolescents with psychiatric problems increased significantly (4.2% vs 2.5%; odds ratio [OR], 1.70; 95% confidence interval [CI], 1.38-2.10), as did ED assessments by a social worker or psychiatrist (2.5% vs 1.7%; OR, 1.47; 95% CI, 1.13-1.90). Of the 857 patients who were screened with the BHS-ED, 90 (10.5%) were identified as having psychiatric problems (OR, 4.58; 95% CI, 3.53-5.94), and 71 (8.3%) were assessed (OR, 5.12; 95% CI, 3.80-6.88).
Conclusions: In a busy pediatric ED, computerized, self-administered adolescent behavioral health screening can be incorporated into routine clinical practice. This can lead to small but significant increases in the identification of unrecognized psychiatric problems.
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Details
- Title
- Feasibility and Effects of a Web-Based Adolescent Psychiatric Assessment Administered by Clinical Staff in the Pediatric Emergency Department
- Creators
- Joel A. Fein - Children's Hospital of PhiladelphiaMegan E. Pailler - Roswell Park Cancer InstituteFrances K. Barg - University of PennsylvaniaMatthew B. Wintersteen - Thomas Jefferson UniversityKatie Hayes - University of PennsylvaniaAllen Y. Tien - Med Decis Log Inc, Baltimore, MD USAGuy S. Diamond - University of Pennsylvania
- Publication Details
- Archives of pediatrics & adolescent medicine, Vol.164(12), pp.1112-1117
- Publisher
- Amer Medical Assoc
- Number of pages
- 6
- Grant note
- H34MC04366 / Maternal and Child Health Bureau, Health Resources and Services Administration, US Department of Health and Human Services; United States Department of Health & Human Services; United States Health Resources & Service Administration (HRSA)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Center for Family Intervention Science
- Identifiers
- 991019292230604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Pediatrics