RTI International



SECTION L: PEDIATRIC AND ADOLESCENT BEHAVIORAL/MENTAL HEALTHDo you have a Pediatric and Adolescent Behavioral/Mental Health program? For purposes of the survey, we are interested in all behavioral/mental health services offered to patients in your children’s hospital from psychiatry, psychology, or other programs that provide behavioral or mental health care to children and adolescents. Unless otherwise specified in the questions below, this includes both inpatient and outpatient services. We recognize that in many hospitals these programs may not be integrated or that they may work separately to address the needs of patients. If you offer behavioral/mental health services at your hospital in any form, we recommend that you indicate that you have a program below and then combine these services for the purposes of the survey. If you have any questions for the project team about what should be included or excluded, please feel free to contact the team at PediatricHospSurvey@.Yes No – Skip to Section L CommentsWhen responding to questions in this section, your hospital must consult with the chief(s) of service (or equivalent) of your Pediatric and Adolescent Behavioral/Mental Health program to ensure that answers are accurate and consistent with both the care delivered and the intent of the survey. We recognize that there may be multiple programs involved in responding to the survey. The survey will collect up to three different service chiefs as points of contact for the survey if needed. We recommend that you include the information for the chief of service for psychiatry and psychology at a minimum in your response; a third service chief option is available if needed for this question.As data are reviewed, U.S. News may have questions about responses to individual questions or about an entire submission. To ensure communication with the appropriate clinical leader(s), please provide the following information about the chief(s) of service (or equivalent) for your Pediatric and Adolescent Behavioral/Mental Health program.Full name:Title:Email:Preferred phone:REQUIRED: IF NAME, TITLE, EMAIL, OR PHONE=BLANK, DISPLAY: “A response is required for [Name/Title/Email/Phone] prior to submitting the survey. Click “OK” to continue with the survey and answer this question later. Click “Cancel” to provide a response to this question now.”L1.1Are you submitting jointly with a Pediatric and Adolescent Behavioral/Mental Health program at another hospital? (e.g., a separate psychiatric inpatient facility)Yes – Go to Question L1.2 No – Skip to Question L2L1.2If yes, what is the name of the Pediatric and Adolescent Behavioral/Mental Health program you are reportingly jointly with? Please note that joint submissions must be reviewed and approved before they are allowed. Before submitting your survey, please contact RTI at PediatricHospSurvey@ to discuss your joint submission request unless you already have received permission to jointly submit data in this specialty. As noted in the instructions for joint reporting, if you are granted permission, only the primary hospital in the joint reporting relationship will be allowed to report data for this specialty.Please indicate the total number of attending/on-staff physicians (excluding fellows) and psychologists (excluding interns or non-licensed fellows) who are currently members of the clinical staff in your Pediatric and Adolescent Behavioral/Mental Health program in the following categories. For each category, please also indicate the total number of full-time equivalents (FTEs) devoted to clinical care. [If none, please enter 0.]Total Physicians& PsychologistsClinical FTEsa.Child and adolescent psychiatrists (include only board certified/board eligible, by the American Board of Psychiatry and Neurology or the American Osteopathic Board of Neurology and Psychiatry with subspecialty certification in child and adolescent psychiatry) ________________b.Attending/on-staff pediatric or child and adolescent clinical psychologists (include only licensed clinical psychologists who have completed their pre-doctoral internship or post-doctoral fellowship training and practice in pediatric or child and adolescent psychology)________________c.Other attending/on-staff physicians or psychologists (include all other attending/on-staff physicians who are not subspecialty board certified/board eligible in child and adolescent psychiatry and all other attending/on-staff psychologists who are not licensed clinical psychologists who specialize in pediatric or child and adolescent clinical psychology) ________________VALIDATE: IF L2x1 IS NOT A WHOLE NUMBER, DISPLAY: “L2x (Total Physicians): Please enter a whole number (no decimals).”Please indicate the total number of nurse practitioners, physician assistants, and clinical nurses (RNs) who work in or directly support your Pediatric and Adolescent Behavioral/Mental Health program. For each category, please also indicate the total number of full-time equivalents (FTEs) devoted to Behavioral and Mental Health clinical care. [Please count staff who work in inpatient and outpatient settings. If none, please enter 0.]Total StaffClinical FTEsa.Nurse practitioners ________________b.Physician assistants ________________c.Clinical nurses (RNs)________________VALIDATE: IF L3x1 IS NOT A WHOLE NUMBER, DISPLAY: “L3x (Total Staff): Please enter a whole number (no decimals).”Please indicate the total number of nurse practitioners, physician assistants, and clinical nurses (RNs) with each of the following certifications. For each category, please also indicate the total number of FTEs devoted to Behavioral and Mental Health clinical care. [Please count staff who work in inpatient and outpatient settings. If none, please enter 0.]Total StaffClinical FTEsa.Nurse practitioners with the Psychiatric-Mental Health Nurse Practitioner (PMHNP-BC) certification________________b.Physician assistants with training in pediatric and adolescent behavior/mental health________________c.Clinical nurses (RN) with the Child/Adolescent Psychiatric-Mental Health Clinical Nurse Specialist certification (PMHCNS-BC), the Pediatric Primary Care Mental Health Specialist (PMHS) certification, Psychiatric Mental Health-Board Certified (PMH-BC) certification, or the Certified Pediatric Nurses (CPN) certification.________________Please indicate the number of fulltime equivalents (FTEs) of licensed masters-level staff dedicated to the clinical care of patients in your Pediatric and Adolescent Behavioral/Mental Health program. [If none, please enter 0.]FTEs a.Licensed marriage, family, and child counselors (MFCC) or Licensed Professional Counselors (LPC) who provide clinical services ________b.Licensed clinical social workers (LCSW) who provide clinical services ________c.Other master’s degree level counselors not covered above with state licensing who provide clinical services________Does your Pediatric and Adolescent Behavioral/Mental Health program provide access to each of the following? (Select all that apply.)Yes, OnsiteYes, via our health systemYes, via a partnershipNo a.Psychiatric/psychological consultation assessment or treatment available in the Emergency Department (ED) 24/7 □□□□b.Consultative liaison service providing assessment and treatment to patients (inpatient and/or outpatient) being treated by other pediatric programs at your hospital □□□□c.Evidence-based psychotherapy treatment for behavior/mental health conditions (inpatient and/or outpatient)□□□□d.Evidence-based behavior therapy treatment for behavior/mental health conditions (inpatient and/or outpatient) □□□□e.Medication management for behavior/mental health conditions (inpatient and/or outpatient)□□□□f.Inpatient psychiatric unit □□□□g.Care coordinators (RNs, social workers, etc.) for patients being treated in the inpatient psychiatric unit □□□□h.The program offers satellite/community clinics, telemedicine, and/or evening/weekend hours to improve access to care □□□□i.School intervention program with providers embedded in schools or available for consultation/training with patients, families, and teachers □□□□j.Integrated behavioral/mental health services in primary care □□□□k.Integrated behavioral/mental health services in medical subspecialty care □□□□l.Partial day hospitalization program □□□□m.Residential program for patients requiring long-term care □□□□n.Multilingual providers who can provide diagnostic and treatment services to those whose first language is not English □□□□o.Assessment and treatment for patients who are deaf or hard of hearing □□□□p.Child Psychiatry Access Programs (CPAP) providing consultation support for other hospitals in the community □□□□q.Program for the care of children with developmental or intellectual disabilities (serving in either a lead or supporting role)□□□□Do you have the following pediatric subspecialists based at your hospital or on-call and available to be on-site 24/7?YesNoa.Adolescent medicine ○○b.Child abuse pediatrics ○○c.Child neurology ○○d.Developmental-behavioral pediatrics ○○e.Sleep medicine ○○Does your Pediatric and Adolescent Behavioral/Mental Health program participate in any collaboratives or research networks?Yes Go to L8.1No Skip to L9L8.1If “yes” to L8, please list all collaboratives and research networks your Pediatric and Adolescent Behavioral/Mental Health program participates in.Does your Pediatric and Adolescent Behavioral/Mental Health program provide access to clinical trials or novel treatments?YesNoDuring 2020, did your Pediatric and Adolescent Behavioral/Mental Health program engage in any of the following activities?YesNoa.Developed and implemented a written plan for program review and quality improvement for the Pediatric and Adolescent Behavioral/Mental Health program ○○b.Determined appropriate data-based performance metrics for clinical quality in Pediatric and Adolescent Behavioral/Mental Health○○c.Track patient data (e.g., diagnoses, treatment plans, test results, emergency department visits, outpatient visits, current treatment regimens, or patient reported outcomes) and other supporting information to measure progress against your clinical quality improvement/performance metrics that are reported to management/leadership in Pediatric and Adolescent Behavioral/Mental Health at least quarterly for all key metrics ○○d.Management/leadership in Pediatric and Adolescent Behavioral/Mental Health presents results of your program’s clinical quality improvement/performance metrics to your clinical staff at least quarterly ○○e.Engaged in one or more clinical quality improvement/performance initiatives focused on improving a specific outcome in Pediatric and Adolescent Behavioral/Mental Health○○f.Reported quality improvement/performance metrics to hospital leadership (e.g., CMO, Department Chair, Committee of the Board of Trustees) at least quarterly○○L10.1If “yes” to L10e, please describe one outcome that you were evaluating and what actions your hospital has taken in the last year to improve care as a result of this clinical quality improvement/performance initiative. [Please discuss what actions your hospital took as a result of this quality initiative and the impact it had on your program.]:Does your Pediatric and Adolescent Behavioral/Mental Health program provide the following services for patients and their families?YesNoa.Education about diagnoses, treatments, and medication options for patients and their families or caregivers ○○b.Support groups for patients ○○c.Support groups for families or caregivers ○○d.Family centered rounds for inpatient care ○○Which of the following specialized treatment programs are available to patients in your Pediatric and Adolescent Behavioral/Mental Health program? [Only select one of the “yes” options if you have an organized program to treat these conditions. Select “no” if you only treat patients with these diagnoses.] (Select all that apply)Yes, onsiteYes, via our health systemYes, via a partnershipNo a.ADHD and disruptive behavior disorders □□□□b.Anxiety disorders □□□□c.Autism spectrum disorders □□□□d.Bipolar disorders □□□□e.Eating disorders □□□□f.Depressive disorders □□□□g.Psychotic disorders □□□□h.Medically complex patients with psychiatric conditions □□□□i.Trauma focused care □□□□j.Substance abuse disorders □□□□k.Other specialized behavioral/mental health treatment program □□□□L12.1If “yes” to L12k, please specify what additional specialized treatment program(s) are offered by your Pediatric and Adolescent Behavioral/Mental Health program.Does your Pediatric and Adolescent Behavioral/Mental Health program conduct the following types of diagnostic assessments?YesNoa.Psychological testing ○○b.Neuropsychological testing○○How many unique inpatients were seen in your inpatient psychiatric unit and in other inpatient medical units by clinical providers in your Pediatric and Adolescent Behavioral/Mental Health program in 2019 and 2020? [Please use both primary and secondary ICD-10 codes in the following ranges: F01-F48, F50-F69, F80-F98.]20192020a.Number of inpatients seen in your inpatient psychiatric unit for evaluation and/or treatment ______________b.Number of inpatients seen in other inpatient units for consults or treatment ______________VALIDATE: IF L14x1 IS NOT A WHOLE NUMBER, DISPLAY: “L14x (2019): Please enter a whole number (no decimals).”IF L14x2 IS NOT A WHOLE NUMBER, DISPLAY: “L14x (2020): Please enter a whole number (no decimals).”How many outpatient visits were conducted by clinical providers in your Pediatric and Adolescent Behavioral/Mental Health program in 2019 and 2020 in each of the following settings? [Please use both primary and secondary ICD-10 codes in the following ranges: F01-F48, F50-F69, F80-F98.]20192020a.In-person outpatient visits ______________b.Telemedicine outpatient visits ______________VALIDATE: IF L15x1 IS NOT A WHOLE NUMBER, DISPLAY: “L15x (2019): Please enter a whole number (no decimals).”IF L15x2 IS NOT A WHOLE NUMBER, DISPLAY: “L15x (2020): Please enter a whole number (no decimals).”Does your Pediatric and Adolescent Behavioral/Mental Health program have multidisciplinary case conference reviews where challenging patient cases are reviewed at least quarterly?YesNoDoes your hospital routinely screen all patients 12 years of age or older for major depressive disorder?Yes No Does your Pediatric and Adolescent Behavioral/Mental Health program screen for substance abuse disorders in pediatric patients 12 years of age or older seen in the ED with a diagnosis involving psychosis?YesNoDoes your Pediatric and Adolescent Behavioral/Mental Health program routinely screen (by use of a standardized instrument(s) or a clinical interview) all patients 12 years of age or older for substance abuse disorders?Yes No For patients with major depression or bipolar disorder being treated by your hospital, does your Pediatric and Adolescent Behavioral/Mental Health program routinely conduct a suicide risk using a standardized instrument or clinical interview?Yes No Does your Pediatric and Adolescent Behavioral/Mental Health program routinely screen all patients being seen for evaluation or care for child abuse?Yes No Does your Pediatric and Adolescent Behavioral/Mental Health program offer each of the following? (Select all that apply)Yes, onsiteYes, via our health systemYes, via a partnershipNo a.Treatment of alcohol dependence □□□□b.Treatment of tobacco use for adolescents □□□□c.Treatment of other drug dependence □□□□Does your Pediatric and Adolescent Behavioral/Mental Health program conduct metabolic monitoring (including body mass index, blood pressure, blood sugar, and cholesterol screening) for patients on antipsychotic medications at least once per year? Yes No Does your Pediatric and Adolescent Behavioral/Mental Health program do each of the following upon discharge from inpatient care at your hospital? YesNoa.Provide coordination of care to ensure that the patient has a follow-up plan after discharge○○b.Schedule follow-up appointments with a provider in your Pediatric and Adolescent Behavioral/Mental Health program or confirm that appointments have been made with a primary care provider (medical or psychiatric) either at your hospital or in the community ○○c.Provide a list of medications and provide any medications necessary at that time of discharge ○○d.Provide notes or transfer of records to the primary care provider (medical or psychiatric) ○○municate with the primary care provider (medical or psychiatric) if patient is a danger to self ○○Does your Pediatric and Adolescent Behavioral/Mental Health program measure care outcomes using standardized patient reported outcomes (e.g., BDI, BYI, BASC, BERS, CDI, CBCL, CHQ, CSI, GAD-7, PHQ-9, PSC, SDQ, YOO)?Yes – Go to L25.1No – Skip to L26L25.1If “yes” to L25, please specify the standardized tools your Pediatric and Adolescent Behavioral/Mental Health program uses to measure care outcomes.Which of the following does your Pediatric and Adolescent Behavioral/Mental Health program currently have in place for your inpatient psychiatric unit?YesNo NAWe do not have an inpatient psychiatric unita.A policy designed to reduce the use of restraints and seclusions/exclusions during inpatient behavior/mental health care○○○b.A tracking mechanism that records the use of restraints and seclusions/exclusions during inpatient behavior/mental health care○○○c.A set target for reducing the number of restraints and seclusions/exclusions during inpatient behavior/mental health care○○○d.Regularly report and discuss with clinical faculty the rate of restraints and seclusions/exclusions for inpatients receiving behavior/mental health care ○○○e.Maintain a standing committee that is charged with reviewing and reducing the use of restraints across the hospital ○○○Did your hospital sponsor (or host a rotation site for) at least 1 pediatric fellow (physician) in the past academic year who is enrolled in an approved Accreditation Council for Graduate Medical Education (ACGME) training program or advanced fellowship in the following subspecialties or 1 post-doctoral intern or fellow who was completing the licensing requirements for clinical psychology in pediatric or child and adolescent psychology? [Note that the fellow can be in any year of their training. You must have had at least 1 fellow or post-doctoral intern in this program at your hospital in the last year to say “yes”; if you have a program but did not have a fellow or post-doctoral intern this past year, you must say “no”. If hosting a rotation, please list the sponsoring institution.]YesNoSponsorChild and adolescent psychiatry○○_____________Neurodevelopmental disabilities○○_____________Adolescent medicine○○_____________Pediatric or child and adolescent psychology○○_____________Pediatric neuropsychology○○_____________As we continue to develop measures for the Pediatric and Adolescent Behavioral/Mental Health specialty survey, we ask for your feedback on questions we are considering for future surveys. At the link below, you will find a list of questions addressing process and outcome measures for this specialty. Please review these potential questions and provide any feedback you have in the space below. [Note that if you need additional space for your feedback, you may upload a document to the Novel Hospital Survey website.] FOR SECTION L:We understand that hospitals have different types of Pediatric and Adolescent Behavioral/Mental Health programs. We encourage you to provide details about your hospital’s program in the space below. Your feedback will help us decide the types of questions to ask in future years. If you need additional space for your comments, you may upload a document to the Novel Hospital Survey website. All other comments, suggestions or questions should be sent to PediatricHospSurvey@. ................
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