Leaving a lasting impact on pediatric mental health care

mother and childA team of over 50 health care professionals is working to change standards of care for pediatric patients who need acute mental health and/or addiction treatment in an emergency setting.

The team, called the “PediAtriC Emergency Mental Health and AddictioNs Care (PACMAN),” is composed of experts from across Alberta who are focused on improving care in the emergency departments of the Stollery Children’s Hospital and Alberta Children’s Hospital.

“The Stollery Children’s Hospital and Alberta’s Children’s Hospital Emergency Departments have seen a significant increase in families seeking care for child mental health issues,” explains Stephen Freedman, team co-lead. “However, the pediatric emergency departments are not able to adequately support these mental health crisis needs and are not necessarily the right fit.”

Patients often encounter the same scenario: families arrive in the emergency departments seeking care, experience long wait times, tell their personal stories multiple times to different health-care professionals, and then receive limited on-site treatment.

“This is where our team is stepping in with a fresh perspective on how to provide care within the emergency departments by focusing on change management and staff training,” says, Mandi Newton, WCHRI member and team co-lead. “We are working closely with families, emergency department and mental health care teams to streamline patient care, provide better options and alleviate pressure on the pediatric emergency departments.”

Redesigning a complex health care system is not an easy task, but the cross collaboration of the two hospitals is propelling this project forward.

“Our teams and hospitals haven’t collaborated on a project like this before, and the dedication and support of the Alberta Health Service teams is so important to the success of this project. Each member’s expertise and relationships within the system is essential to imbedding and monitoring change in the emergency departments,” adds Christine Mummery, operational project contributor.

Families are also taking an active role on project committees or providing feedback on an ongoing basis as the project evolves. Client feedback will continue to be important to monitoring how changes are affecting patient experience and care.

Currently the PACMAN team is in the preparation phase developing tools, change management strategies, protocols, procedures and communication plans. Once approved, these documents will play an important role in supporting the clinical leaders as they roll out the project in a clinical setting.

Next steps will be to evaluate the current state of care over an eight-month period. This will entail monitoring wait times, number of children and youth accessing the emergency department for mental health, and gathering feedback from families accessing care. Once that assessment is complete, new tools and models will be rolled out initially at the Stollery. Tools and models will address specific needs in each emergency setting and may differ. Changes will be evaluated in real-time with quality improvement and change management processes in place. This will allow for continual evaluation (daily, weekly or monthly) and quality improvements to be made over the next few years.

Eventually, the team wants to see a redesigned system with robust process documentation, evidence that the tools and procedures are working, and the ability to have the system adapt as pediatric mental health care needs evolve. They also hope to see families and patients more satisfied with the care they receive.

“What is fantastic about this project is that we are leaving a legacy. Long after our part of the project is finished, we will leave a clinical footprint that will support future teams involved in providing mental health services to children and youth,” says Newton.

This project was funded in part through the Stollery Children’s Hospital Foundation through the Women and Children’s Health Research Institute.

Stollery Children's Hospital Foundation

PediAtriC Emergency Mental Health and AddictioNs Care (PACMAN) Team:

Mandi Newton, team co-lead, associate professor, Department of Pediatrics, Clinician Scientist, Child and Adolescent Psychiatry Research, Faculty of Medicine & Dentistry, University of Alberta
Stephen Freedman, team co-lead, associate professor of Pediatrics, Alberta Children’s Hospital, University of Calgary
Linda Anderson, manager, Psychiatric Emergency Service (PES), Alberta Children's Hospital
Christine Mummery, director, Child and Adolescent Addiction and Mental Health Services, Alberta Health Services, Edmonton Zone
Andrea Perri, director, Child and Adolescent Addictions, Mental Health and Psychiatry Program, Acute Care, Alberta Health Services, Calgary Zone
Antonia Stang, medical director, Pediatric Emergency Medicine, Alberta Children's Hospital
Bruce Wright, medical director, Pediatric Emergency Medicine, Stollery Children's Hospital

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