Texting as a Means of Reducing Pediatric Adolescent Psychiatric Emergency Encounters Wait Times.

Abstract

There is no universal system to facilitate communication between emergency rooms (ERs) and pediatric mental health providers, which leads to long wait times. This project tested the concept that a group texting application (GroupMe) could improve communication between providers and could reduce wait times by allowing frontline workers to contact multiple providers simultaneously. We compared total wait times or overall length of service of 906 ER encounters before and 921 encounters after the GroupMe texting application was implemented. To reduce differences between preintervention and postintervention time points, we utilized propensity score matching to generate a matched group of controls (total sample n = 831 ER encounters before and n = 831 ER encounters after). Although there were no differences in total wait times when using the GroupMe application, there was a significant decrease in wait times after patients were diagnosed in ER by psychiatric provider both before (mean difference, 96.4 minutes saved; t = 2.23; P < 0.05) and after propensity score matching (mean difference, 88.0 minutes saved; t = 2.48; P < 0.05) for disposition type and acuity level. Use of a group texting application has the potential to improve communication and wait times. However, its ability to reduce overall wait times is hampered when the limited availability of pediatric psychiatry providers results in delays in diagnosis and treatment decisions.