ArticleJournal of patient safety2025
Evaluating Safety Concerns for Pediatric Mental and Behavioral Health Patients and Providers in the Emergency Department: A Systems Perspective.
Article in Journal of patient safety, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
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Abstract
objectiveThe objective of this study was to determine key issues related to the safety of pediatric mental and behavioral (MBH) patients in the emergency department (ED), as well as related provider safety issues from a systems perspective.
methodsSemistructured interviews were conducted with 55 staff members from 4 ED units in rural and urban hospitals. Utilizing the Systems Engineering Initiative for Patient Safety framework, interviews were coded in Atlas.ti for physical environment, tasks, roles, technology, organization, and safety.
resultsSelf-harm, harm to others, and elopement were the frequently mentioned safety concerns. The type of ED (general adult, non-MBH unit) and presence of ligatures in patient care areas increased risks to patient safety. ED layout, patient visibility, and proximity to exits increased elopement risks. The ED environment was seen as a trigger for patient agitation, exacerbating MBH conditions. Major challenges in safety incident prevention and response included inadequate pediatric de-escalation training and ineffective use of protective shields. Technological barriers affecting safety encompass issues with the accessibility and reliability of panic buttons.
conclusionsThe study calls for a comprehensive approach to safety in the ED, integrating organizational policies, environment design, technology use, staff training, and resource management, setting the stage for future enhancements in safety for both pediatric MBH patients and health care providers.
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