Changing Face of Health Care for Youth

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Published on April 06, 2017

Changing Face of Health Care for Youth

Dr. Sarah Radwan and Erin Collins

Dr. Sarah Radwan and Erin Collins, BSN, RN

Fewer beds for juveniles at the New Hampshire (psychiatric) Hospital has meant major changes for the Pediatrics patient care unit at Concord Hospital.

In the past, many behavioral health pediatric patients would have been evaluated in the Emergency Department and waited in the department’s behavioral health holding area for a few hours until they could be transferred to New Hampshire Hospital. Now they often are admitted to the Pediatrics unit instead for far longer periods as they wait for transfer.

"The challenge of meeting behavioral health needs of pediatric patients will grow and Concord Hospital will continually re-evaluate the needs of children and their families, the environment of care and the education and support of clinical teams."

~ Erin Collins, BSN, RN, Director of The Family Place at Concord Hospital, Maternal Child Services

To meet the challenges of receiving patients for which the unit was not designed and its providers not trained, The Family Place provided training, hired more staff , began programs to help pediatric behavioral health patients move toward treatment. It also increased collaboration between providers, developed specialized care plans and began participating in
a Hospital-wide team that responds to behavioral health emergencies.

While patients of any age with mental health emergencies are often held in secure, sterile, windowless areas for their safety, children will frequently deteriorate in these surroundings. The changes at Concord Hospital bring pediatric behavioral health patients into a calmer setting, with special attention to prevent their condition from worsening as they await transfer to appropriate care.

"The biggest difference is that we have worked very hard to change how threatening a period of crisis feels to kids."

~ Dr. Sarah Radwan, Pediatric Hospitalist

It’s demanding work that often requires one-on-one attention, around the clock. The unit hired more licensed nursing assistants to help provide that attention. In 2016, the unit used philanthropic funding to begin a program called WRAP (Wellness Recovery Action Plan) to train staff and provide patients with methods to help them identify triggers that set o a crisis, and ways to help feel more calm and balanced.

The unit also has increased collaboration with psychiatrists and the pediatric care team to keep patients safe and evaluate procedures and care to improve their response, especially with patients they see repeatedly. The collaboration includes a Behavioral Emergency Response Team that can help with concerns around the clock.

The number of children admitted with behavioral health issues in the Pediatrics patient care unit steadily increased from three in 2009 to more than 100 in the first ten months of 2016. Thirty-one of the 2016 patients required round the clock, one-on-one supervision.

At the same time, the unit cared for more than 700 other pediatric patients. The challenge of meeting the behavioral health needs of pediatric patients will grow and Concord Hospital will continually re-evaluate the needs of children and their families, the environment of care and the education and support of clinical teams.

Media Contact

Public Affairs
Concord Hospital
250 Pleasant St.
Concord, NH 03301
(603) 227-7000, ext. 4215