A Pediatric Emergency Medicine and Psychiatry Collaboration: An Intervention Time Series Analysis of the Length of Stay for Pediatric Mental Health Emergency Department Visits

We evaluated a pediatric emergency medicine (PEM) psychiatry collaborative intervention designed to streamline mental and behavioral health (MBH) patient management and reduce emergency department (ED) length of stay (LOS). Using electronic health record (EHR) data from 151,014 pediatric emergency department (PED) visits at a single urban PED in South Carolina between October 1, 2017, and November 30, 2023, we evaluated an intervention implemented on April 1, 2023 in which PEM physicians performed initial evaluations and promptly consulted psychiatry post-medical stabilization. Psychiatry then managed stable MBH patients through discharge or inpatient admission. An interrupted time series analysis with an ARIMA model assessed LOS among 8,791 pediatric MBH patients. The intervention system significantly reduced LOS by 81.3 min for MBH patients in the PED ( p < .001). Future research should replicate this intervention in diverse healthcare settings to assess generalizability and further refine strategies for improving care for pediatric MBH patients.