O3325: Behavioral Health Vehicle Initiative: A Children's Health Dallas Experience

Purpose/Objectives: At Children’s Health-CMC, Dallas we launched an initiative in July ’22 to improve timeliness in time to transfer pediatric psychiatric patients from our emergency department to contracted inpatient behavioral health beds at other facilities. The Behavioral Health Vehicle (BHV) Initiative involved utilization of customized vehicles, operated by paramedics to safely and efficiently transport psychiatric patients to inpatient psychiatric facilities.

Aims:
-To decrease the time to transport once a psychiatric patient has been accepted at a behavioral health facility and reduce the burden on the ED.
-To improve patient experience
-To improve availability of ambulances for critically ill children.

Design/Methods: We purchased two sports utility vehicles, installed safety equipment in these vehicles, and hired skilled paramedics to operate and staff the cars. The vehicles were retrofitted with modifications to keep all passengers safe and prevent patient elopement
The BHV crew included 2 paramedics and could seat a family member along with the patient during the transport
We launched the program with 2 customized vehicles in the 10 am-10 pm timeframe in July ’22. Our BHV Initiative program applied for a Substance Abuse &Mental Health Services Administration (SAMHSA) grant and were awarded $ 500,000 over a program beginning September 30, 2023, and ending September 29, 2024. With the NIH grant we increased our fleet to 4 customized BHV vehicles and hired personnel to staff it.

Results: We performed 190 transports using the BHV in the September 30, 2023, and ending September 29, 2024.
-The BHV reduced the median time to transport to inpatient psych facilities by 58 minutes.
In the time frame of 10 pm-10 am, in the absence of the BHV fleet and personnel, when the patients had to wait for our ambulance, the median time taken to transport the patient once he/she was accepted at an inpatient facility was 95 minutes. During 10 am-10 pm time frame, with the BHV fleet and personnel the time taken to transport once the patient was accepted by a psych facility was 37 minutes.
-There were no safety events
-Improved patient experience for this mentally vulnerable population since the ride in the BHV vehicles, fitted with mood lighting and music was appreciated over the ride in a regular ambulance

Conclusion/Discussion: We have had zero safety events since the launch of this initiative, and, we have improved the patient transport experience while saving the ambulances for the critically ill children.
Our initiative is among the first in the country where we offer a safe, welcoming environment for children dealing with mental health crisis and we remain committed to making life better for children.