Angela Mowder, nurse manager of the inpatient behavioral health unit, helped use feedback from staff to develop new service
Like the parents who turn to the emergency department (ED) when their child is sick or injured, parents with a child experiencing a mental health crisis now have a secure place to go for help.
In 2010, Akron Children’s Hospital opened a unit in its ED dedicated to children and teens suffering with mental and behavioral health issues. The Emergency Services Behavioral Health Unit is the first of its kind in the area.
It’s estimated that nearly 1 in 5 children and adolescents struggle with a mental health condition. Because of a national shortage of pediatric psychiatrists, waiting lists for treatment and the stigma surrounding mental illness, these children and teens may not receive the care they need. Instead, many families have relied on emergency departments as a safety net for mental health services.
The Akron Children’s Hospital Emergency Services Behavioral Health Unit was designed to specifically meet the needs of this patient population. Throughout the design and planning process, direct-care nurse input was sought.
A group of parents through Akron Children’s Parent Advisory Council also provided feedback.
The recommendations from direct-care nursing staff, as well as Security Services, helped to create a calm and soothing environment. The entire unit is bathed in soft lighting and without the noisy drone of hospital equipment or the hectic pace of the ED, which can further agitate at-risk kids.
The unit’s five rooms include safety features such as video monitors and safety mirrors in the restrooms. There’s also a private waiting room, respite area for families and restricted access to the public.
ER nurse manager, Brian Carr, and nursing director Helen Raub were part of the leadership team responsible for opening the new unit
“We are focusing on the needs of these patients and families in everything we do,” said nursing director Helen Raub, BSN, MBA, RN. “To create a safe and therapeutic environment, we have installed dimmer lights, eliminated unnecessary wiring and equipment, and implemented measures to reduce the risk of flight. Whether it is a child with autism or a teen in crisis, we have the environment and the trained staff to de-escalate behavior and facilitate patient assessment and stabilization.”
Raub co-chaired an interdisciplinary task force, along with emergency medicine physician Timothy Lee, MD, that evaluated the concept of the unit and determined how to best allocate limited resources, support primary care physicians and collaborate with community agencies focused on mental and behavioral health.
A subcommittee was also formed to develop the unit’s staffing plan, which included direct-care nurse members.
Families have benefitted from the unit’s services, which are provided 24/7 and include emergency psychiatric evaluations, crisis stabilization, brief outpatient counseling, and consultation and support for family members.
Since its inception, the unit has served more than 2,000 patients. Staff safety has also improved with population-specific care.
Prior to the unit opening in September 2010, ED staff reported four to five work-related injuries per year and averaged 46 security staff hours per month. Since opening, there have been no work-related injuries and security staff hours decreased by more than 25 percent to 34 staff hours per month.
Children’s Hospitals Today recognized the unit as an innovative solution for care delivery for pediatric mental health patients in crisis. ED Management presented the staff with the first Gold Star Award for going “above and beyond” to dramatically improve performance through unique and creative approaches.
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