Using patient journey mapping and provider workflows to understand process barriers to pediatric mental and behavioral health care in emergency departments

IF 3.1 2区工程技术 Q2 ENGINEERING, INDUSTRIAL

Applied Ergonomics Pub Date : 2025-03-28 DOI:10.1016/j.apergo.2025.104512

Devi Abhishek Soman , Samuel Nelson Koscelny , David Neyens , Ann Dietrich , Meera Narasimhan , Kevin Taaffe , David Allison , RIPCHD.PED Study Group , Anjali Joseph

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Abstract

With the rise in mental and behavioral health (MBH) conditions among school-age children in the United States (US), the number of Emergency Department (ED) visits have also increased. However, ED settings struggle to meet the needs of children with MBH conditions safely and efficiently. This study integrated SEIPS (Systems Engineering Initiative for Patient Safety) 3.0 and 2.0 frameworks to explore the temporal and non-linear aspects of pediatric MBH patients’ journey and work processes (professional, patient, and collaborative work) to identify process barriers to pediatric MBH care in the ED. This mixed-method, multiple case study used observations, staff interviews, and time stamps of patient visits from electronic medical records at four EDs in the south-eastern US to inform the integrated patient journey and staff workflow process maps. Most barriers identified related to “medical and psychiatric evaluations” and “disposition and treatment plan” segments of the patient journey, suggesting potential points for interventions.

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使用病人旅程图和提供者工作流程来了解急诊科儿科精神和行为卫生保健的流程障碍

随着美国学龄儿童心理和行为健康（MBH）状况的增加，急诊科（ED）就诊的数量也有所增加。然而，急诊科的设置很难安全有效地满足MBH患儿的需求。本研究整合了SEIPS（患者安全系统工程计划）3.0和2.0框架，探索儿科MBH患者旅程和工作流程（专业、患者和协作工作）的时间和非线性方面，以确定急诊科儿科MBH护理的流程障碍。以及美国东南部四家急诊科的电子病历中患者就诊的时间戳，以便为综合的患者旅程和员工工作流程地图提供信息。确定的大多数障碍与患者旅程的“医疗和精神评估”和“处置和治疗计划”部分有关，这表明了干预措施的潜在点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Applied Ergonomics 工程技术-工程：工业

CiteScore

7.50

自引率

9.40%

发文量

248

审稿时长

53 days

期刊介绍： Applied Ergonomics is aimed at ergonomists and all those interested in applying ergonomics/human factors in the design, planning and management of technical and social systems at work or leisure. Readership is truly international with subscribers in over 50 countries. Professionals for whom Applied Ergonomics is of interest include: ergonomists, designers, industrial engineers, health and safety specialists, systems engineers, design engineers, organizational psychologists, occupational health specialists and human-computer interaction specialists.