Assessment of statewide initiative for children boarding in rural emergency departments with mental health concerns

Abstract

Children presenting to emergency departments (ED) for mental health concerns have increased nationally, resulting in ED boarding due to the lack of infrastructure for needed treatment. 1,2 ED boarding is defined by The Joint Commission as "the process of holding patients in a temporary location after the decision to admit or transfer has been made" and recommends a duration of less than 4 h. 3 The majority of children in the United States are evaluated and board in general EDs where there is limited pediatric or psychiatry expertise. 4,5 Despite the ongoing mental health crisis, 6 few interventions to improve the experience of boarding children and adolescents in the ED have emerged. This is especially true for general and critical access EDs who have requested more guidance on safe activities to provide pediatric patients while boarding. 7 We therefore implemented a statewide initiative in rural EDs through distribution of (1) youth activity kits and (2) a self-care activity binder designed to assist staff in caring for children boarding with primary mental health concerns. The youth activity kits contained assorted toys, games, art/sound supplies, meditation, and distraction items. The self-care activity binders included team communication enhancements, mindfulness activities, and fitness activ-How to cite this article: Pulcini CD, Schneider S, Wolfley H, Collins B, Li J. Assessment of statewide initiative for children boarding in rural emergency departments with mental health concerns.