An Evaluation of Satisfaction with Emergency Department Care in Children and Adolescents with Mental Health Concerns
Date
2022-05-06
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Abstract
The emergency department (ED) is a vital safety net for children and adolescents with mental health concerns seeking crisis care. Yet, EDs face significant challenges in managing mental health concerns. Evaluating patient and parent/caregiver satisfaction with care delivery is essential to guide improvements in the quality of mental health services provided. This study involved enrolling participants over a 12-month period to evaluate child/adolescent and parent/caregiver satisfaction with mental health care in two pediatric EDs. Patients <18 years of age presenting with a range of mental health concerns (e.g., anxiety, disruptive behaviours, self- harm, depression, situational crisis) were eligible and enrolled. Discharge diagnoses were grouped by ICD-10-CA codes. Data were collected using the Service Satisfaction Scale. I conducted Pearson’s correlation coefficient tests to report associations of general satisfaction with individual aspects of ED care, multivariable regression analysis to report associations of total satisfaction score with patient and clinical care characteristics, and inductive thematic analysis to identify and describe satisfaction and patient experience themes from qualitative feedback. The study included 646 participants, the majority of whom were Caucasian (71.2%; 460/646), female (56.3%; 364/646). The median age of patients was 13 years (IQR, 11-15 years). The most common diagnoses among participants were anxiety or stress-related disorders (39.5%; 245/620), suicidal ideation (26.0%; 161/620), and mood disorders (25.0%; 155/620). The perception of the amount of help a child received during the visit was most strongly associated with general satisfaction (r=0.85). Clinical care characteristics associated with satisfaction were receipt of an evaluation by a mental health team member (p=0.004) and consultation by a psychiatrist (p=0.05) during the ED visit. Themes that emerged from the thematic analysis included satisfaction with the ED health care team’s attitude and interpersonal skills and dissatisfaction with standards of care expectations, wait time for care, and general access to mental health care. Overall, the results point to the need to improve the satisfaction with ED mental health care delivery with a particular focus on enhancing access to care to mental health providers with expertise (e.g., mental health nurses, counsellors, psychiatrists).
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Keywords
emergency department, mental health, paediatrics, children, adolescents, mental health care, emergency department care, patient-oriented, satisfaction, patient satisfaction, patient experience
Citation
Lategan, C. (2022). An Evaluation of Satisfaction with Emergency Department Care in Children and Adolescents with Mental Health Concerns (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.