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Utilization and Emergency Department Diversion as a Result of Pediatric Psychology Trainees Integrated in Pediatric Primary and Specialty Clinics

Title: Utilization and Emergency Department Diversion as a Result of Pediatric Psychology Trainees Integrated in Pediatric Primary and Specialty Clinics
Authors: Pereira, Lila M.; Wallace, Jenna; Brown, Whitney; Stancin, Terry
Contributors: American Psychological Association; Case Children’s Access Now; Ohio Department of Medicaid Workforce Development Program; Medicaid Technical Assistance and Policy Program
Source: Clinical Practice in Pediatric Psychology ; volume 9, issue 1, page 58-67 ; ISSN 2169-4826 2169-4834
Publisher Information: SAGE Publications
Publication Year: 2021
Description: Purpose: Integrating behavioral health into primary care (PC) is known to be an effective approach to caring for children with complex health care needs. The purpose of this study was to describe the impact of embedding predoctoral psychology interns (PSY residents) in a continuity care clinic on behavioral health care utilization with additional attention paid to diverting emergency department (ED) visits. Method: Doctoral psychology PSY residents participated as team members in pediatric resident continuity care clinics and also were available to consult with specialty and urgent care clinic providers within the ambulatory center. During a 6-month period, services provided by PSY residents were tracked (numbers of warm-handoffs, behavioral consults [ including covisits with pediatric residents ] , psychotherapy appointments, and crisis evaluations). Results: PSY residents completed 184 warm-handoffs, 250 same-day consults, and 223 follow-up appointments. Sixty-five patients attended group therapy sessions offered in the pediatric clinic. Of 23 patients evaluated for suicidal/homicidal ideation (who previously would have been referred immediately to the ED), 21 were stabilized in PC and only 2 required ED services. Conclusion: Integration of PSY trainees resulted in more than 700 rapid behavioral health services in 6 months, and diverted 91% of mental health crises from ED and other possible psychiatric hospitalization. Prior to integration, none of these services were provided on site. In addition to providing interprofessional team training, integrated continuity care clinics can improve access to behavioral health services and offer significant cost-saving opportunities to health care systems. Ways to promote interdisciplinary training will be identified. Implications for Impact Statement Embedding predoctoral psychology interns in a pediatric continuity care clinic can result in increased access to behavioral health clinicians and division of emergency department visits for high-risk patients. This model ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.1037/cpp0000315
Availability: https://doi.org/10.1037/cpp0000315; https://journals.sagepub.com/doi/pdf/10.1037/cpp0000315; https://journals.sagepub.com/doi/full-xml/10.1037/cpp0000315
Rights: https://journals.sagepub.com/page/policies/text-and-data-mining-license
Accession Number: edsbas.DC220ABB
Database: BASE