4.53 STREAMLINING EMERGENCY DEPARTMENT MENTAL HEALTH DISCHARGE PLANNING USING THE ELECTRONIC HEADS-ED SCREENING TOOL

Objectives: The three objectives of this study were as follows: 1) to pilot a newly developed web-based HEADS-ED screening tool in the emergency department (ED); 2) to provide a customized list of resources for ED clinicians to provide to each mental health (MH) patient for discharge planning; and 3) to determine patient's perspectives of the usefulness and practicality of tailored community MH recommendations. Methods: Five hundred children and youth presenting to a pediatric ED for MH care between the ages of 6-17 years participated in the study. The first 250 patients in phase 1 presented to ED between February 23, 2015 and September 14, 2015. The paper version of the HEADS-ED screening tool was administered by physicians and crisis workers. Demographic and outcome data were collected as patients received usual ED care. In phase 2, patients presented to the ED between September 15, 2015 and May 2, 2016. Clinicians completed the web-based HEADS-ED screening tool for enrolled patients. MH service recommendations linked to ementalhealth.ca were based on the needs identified by the web-based HEADS-ED. These resources were customized by patient age, sex, language, and region. A printout of the recommendations was provided to each patient and/or caregivers All patients consented to completing a follow-up survey 30 days post-ED presentation to appraise the satisfaction with discharge recommendations at the time of enrollment. Results: Approximately 65 percent of clinicians completed the paper version of the HEADS-ED in phase 1 compared with 82 percent of clinicians completing the electronic version of the HEADS-ED in phase 2. No significant differences in HEADS-ED scores were found between participants in phases 1 and 2. Approximately half of the sample group was reached to complete the follow-up survey on their appraisal of discharge recommendations. Those who were provided with the HEADS-ED recommendations in phase 2 found the tailored recommendations to be more useful (69.5 vs. 30.5 percent) and more practical (71.8 vs. 28.2 percent) compared with those who did not. Conclusions: The web-based HEADS-ED screening tool is more likely to be used by ED clinicians to inform patient discharge recommendations and to link to specialized MH community resources. Patients who were provided with a list of community MH resources when discharged from the ED rated the recommendations as more favorable compared with usual care.