Inpatient Clinical Pathway for Children with
Behavioral Health Discharge Disposition
Inpatient at PHL or KOPH Evaluated for Behavioral Health (BH) Disposition
- Initiate
- Behavioral Health Consult and Discharge Panel
- Unit Social Work (SW) consult
- Review need for Behavioral Health Provider Consults
- Schedule multidisciplinary family meeting as indicated
- Discuss discharge care options using mutual decision-making
- Review Medical Clearance Evaluation
- SW or Behavioral Health Integrated Program (BHIP)
- Determines discharge care acuity level
- Documents in BHIP note
Low Acuity
Outpatient services
Intermediate Acuity
High Acuity
- Acute inpatient hospitalization
- Psychiatry completes:
Voluntary Admission/ Involuntary Commitment Forms
- Psychiatry completes:
Discharge/Transfer Process
- Update medical clearance status in Behavioral Health Consult and Discharge Panel
- BH SW Disposition Team coordinates discharge
- Document in daily medical progress note assessment section:
- Patient is medically cleared, awaiting BH disposition planning
- Follow routine discharge processes with additional actions below
Low Acuity Discharge Actions
- Medical Team
- Schedule PCP follow-up appointment
- Confirm with BHIP Safety Plan completed, reviewed
- If applicable; include in AVS
- Nursing
- Follow routine discharge workflow
- Unit Social Work
- Provides outpatient BH resources or refers case to BH SW disposition team as appropriate
- Centralized BH SW Disposition Team [PHL SW Disposition]
- Schedule BH outpatient appointment
- Review with patient/family
- BH appointment time, location
- Provide list of resources, at request of BHIP
- Follow-up call day after discharge & day after scheduled appointment
- Additional resources, if necessary
Intermediate Acuity Discharge Actions
- Medical Team
- Schedule PCP follow-up appointment
- Confirm with BHIP Safety Plan completed, reviewed
- If applicable, include in AVS
- Nursing
- Follow routine discharge workflow
- Unit Social Work
- Refers to centralized BH SW Disposition team
- Centralized BH SW Disposition Team [PHL SW Disposition]
- Refer recommended BH program
- Complete referral packet
- Ensures insurance pre-authorization
- Secure intake date if available
- Follow-up call day after discharge and day after scheduled appointment
- Additional resources, if necessary
High Acuity Transfer Actions
- Medical Team
- Notify PCP about transfer
- Obtain transport consent
- Nursing
- Request inpatient clerk print Voluntary Admission/ Involuntary Commitment Forms and include with paper chart
- If notified by SW, complete RN-to-RN handoff through transport
- Complete transport checklist
- Unit Social Work
- Refers case to SW BH disposition coordinator
- Care coordination between BH SW disposition and care teams
- Centralized BH Disposition Team [PHL SW Disposition]
- Coordinates transportation
- Completes necessary documentation
- Review options for placement with patient/family
- Completes insurance pre-authorization
- Fax psychiatric assessment to appropriate facilities
- Facility Placement
- Facility accepts patient for transfer
- Patient/family and medical team informed
- Transport department completes transfer
Evidence
- Common and Costly Hospitalizations for Pediatric Mental Health Disorders
- Predictors for Readmission into Children’s Inpatient Mental Health Treatment
- Postacute Care After Pediatric Hospitalizations for a Primary Mental Health Condition
- Psychiatric Disorders and Trends in Resource Use in Pediatric Hospitals
