The HEADS-ED

Cappelli, Mario; Zemek, Roger; Polihronis, Christine; Thibedeau, Nathalie R.; Kennedy, Allison; Gray, Clare; Jabbour, Mona; Reid, Sarah; Cloutier, Paula

doi:10.1097/pec.0000000000001180

Cited by 27 publications

(23 citation statements)

References 23 publications

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“…Offering select adult medical patients a clinic visit instead of remaining in the ED has been described as safe and effective [ 28 , 29 ]. The use of HEADS-ED to guide assessments and decision-making has also been studied in other EDs [ 16 , 30 , 31 ]. We introduced it to also support interprofessional communication between ED physicians, mental health nurses, and psychiatrists.…”

Section: Discussionmentioning

confidence: 99%

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Use of quality improvement methods to enhance implementation of a mental health care bundle in a pediatric emergency department

et al. 2023

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Objectives We used quality improvement methods to implement a care bundle for children presenting to a pediatric emergency department (ED) with mental health concerns. A bundle novelty was that it included an option for assessment in a partnered clinic, not in the ED, to families of children assessed as having no medical or safety concerns. The primary aim of this study was to establish successful implementation of the bundle prior to studying its impact. Methods The bundle included the Ask Suicide-Screening Questions to standardize risk assessment at triage, the HEADS-ED (Home, Education, Activities/Peers, Drug/Alcohol, Suicidality, Emotions/Behavior, Discharge Resources) tool for brief, scored mental health assessments, and offering an urgent appointment within 96 h for low-risk children as an alternative to ED-based assessment or as a follow-up option for patients assessed in the ED. We developed aims, driver diagrams, and outcome measures for each bundle element. Each element was introduced with small tests of change using iterative plan-do-study-act cycles. Run charts were used to determine successful completion of aims. Results Rules for special cause were met through detection of shifts in performance 5 months after bundle implementation for the Ask Suicide-Screening Questions and HEADS-ED. These bundle elements were consistently used with ≥ 80% of eligible patients, representing aim achievement. During the 6 months of providing urgent appointments, 89.3% of 159 referred families received an appointment within 96 h. Conclusions Using quality improvement methods, we were able to successfully ensure reliable implementation of a new care bundle for pediatric patients presenting to the ED with mental health concerns and allow eligible low-risk patients to receive full assessments in a partnered clinic instead of the ED. Supplementary Information The online version contains supplementary material available at 10.1007/s43678-023-00476-4.

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Section: Discussionmentioning

confidence: 99%

“…The tool facilitated focused assessments with patients and guided nurse/physician decision-making for psychiatrist consultation and discharge planning [ 2 ]. The tool has excellent inter-rater agreement [ 16 ] and was originally developed to aid physician assessment [ 15 , 16 ].…”

Section: Methodsmentioning

confidence: 99%

Use of quality improvement methods to enhance implementation of a mental health care bundle in a pediatric emergency department

et al. 2023

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“…The closest instrument to HEARTSMAP in this regard is HEADS-ED, the only other known tool designed specifically to assess youth in the ED. Cappelli et al compared inter-professional agreement between crisis intervention workers and paediatric emergency physicians in screening a sample of 140 patients using HEADS-ED (26). Scores on HEADS-ED lead to a binary outcome: requires further MH assessments and interventions, or not.…”

Section: Discussionmentioning

confidence: 99%

Reliability testing of the HEARTSMAP psychosocial assessment tool for multidisciplinary use and in diverse emergency settings

Virk

Stenstrom

Doan

2018

Paediatrics &Amp; Child Health

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Objective: HEARTSMAP is a tool developed to facilitate assessment and management of paediatric mental health (MH) patients by emergency department (ED) clinicians. We evaluate the inter-rater reliability of HEARTSMAP when administered by clinicians of various backgrounds. Methods: In a cross-sectional study initiated in 2016, collaborating clinician evaluators (n=16) applied the HEARTSMAP tool to evaluate a set of 50 fictional clinical vignettes, digitally in an approach consistent with the anticipated tool's access and usage in clinical settings. Evaluators came from different types of health centres from across the province of British Columbia (Canada), including remote/ rural, regional and urban academic health centres. Results: We report moderate to near excellent agreement, overall among clinicians for all 10 of the tool's psychosocial sections (κ=0.43 to 0.93) and domain scores (κ=0.75 to 0.90), with acceptable agreement across all tool-triggered service recommendations (κ=0.36 to 0.65). Conclusions: Our findings show that HEARTSMAP may be reliably used by ED clinicians in assessing MH issues among youth. Results from this study will assist in informing the wider clinical implementation of HEARTSMAP as a standard assessment tool, in diverse emergency care settings.

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“…Tools to quickly and easily access information about local resources should also be available in the ED so that providers can direct patients to appropriate community resources. 43 Variation between the study EDs, in terms of who uses them and why, points to the necessity of providing a variety of resources to meet variation in population and patient need. Clinical management across sites indicated significant differences for medical care and psychiatric consultations.…”

Section: Discussionmentioning

confidence: 99%

Evaluating mental health service use during and after emergency department visits in a multisite cohort of Canadian children and youth

Cappelli

Cloutier

Newton

et al. 2017

CJEM

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The HEADS-ED

Cited by 27 publications

References 23 publications

Use of quality improvement methods to enhance implementation of a mental health care bundle in a pediatric emergency department

Use of quality improvement methods to enhance implementation of a mental health care bundle in a pediatric emergency department

Reliability testing of the HEARTSMAP psychosocial assessment tool for multidisciplinary use and in diverse emergency settings

Evaluating mental health service use during and after emergency department visits in a multisite cohort of Canadian children and youth

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