@article{ref1,
title="Experiences of child and adolescent psychiatric patients boarding in the emergency department from staff perspectives: patient journey mapping",
journal="Administration and policy in mental health",
year="2023",
author="Wolff, Jennifer C. and Maron, Micaela and Chou, Tommy and Hood, Erik and Sodano, Sophia and Cheek, Shayna and Thompson, Elizabeth and Donise, Kathleen and Katz, Emily and Mannix, Margaret",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Over the past decade, healthcare providers nationwide have contended with a growing boarding crisis as pediatric patients await psychiatric treatment in emergency departments (EDs). COVID-19 has exacerbated this urgent youth mental health crisis, driving EDs to act as crisis units. Journey mapping is a robust methodology with which to examine strengths and challenges in patient care workflows such as boarding and emergency psychiatric care. Psychiatric, emergency medicine, and hospitalist providers serving patients boarding at a northeastern children's hospital participated in semi-structured qualitative interviews. Investigators conducted directed content analysis with an inductive approach to identify facilitators, barriers, and persistent needs of boarding patients, which were summarized in a patient journey map. <br><br>FINDINGS were presented to participants for feedback and further refinement. Quantitative data showed a three-fold increase in the number of patients who boarded over the past three years and a 60% increase in the average time spent boarding in the ED. Emergent qualitative data indicated three stages in the boarding process: Initial Evaluation, Admitted to Board, and Discharge. Data highlighted positive and negative factors affecting patient safety, availability of beds in pediatric hospital and psychiatric inpatient settings, high patient-provider ratios that limited staffing support, and roadblocks in care coordination and disposition planning. Patient journey mapping provided insight into providers' experiences serving patients boarding for psychiatric reasons. <br><br>FINDINGS described bright points and pain points at each stage of the boarding process with implications for psychiatric care and systemic changes to reduce boarding volume and length of stay.<p /> <p>Language: en</p>",
language="en",
issn="0894-587X",
doi="10.1007/s10488-022-01249-4",
url="http://dx.doi.org/10.1007/s10488-022-01249-4"
}