A Virtual Rapid Response Pathway for Risk Management through COVID-19

ABSTRACT

COVID-19 related restrictions made it necessary for mental health outpatient care to abruptly transition to virtual care. For some youth and families, multiple stresses related to isolation, loss of friend and family supports, school cancellation are exacerbated by financial stress, limited parenting skills and challenges with emotion regulation. Such situations put young people at risk for deteriorating mental health and conflictual family situations, which could lead to Emergency (ED) presentations, admission, and child protective service or police involvement. At-risk young people include current outpatients, those who have been referred but not seen, and patients presenting to ED. Methods: A system was developed for categorizing all patients as high, medium or low risk and an algorithm de-veloped as to level of intervention required for each. All patients on the waitlist were triaged for risk level. A pathway was developed to have high risk patients referred from ED seen virtually within 3 days and other high risk patients monitored closely. Patient flow was adjusted to allow flexible matching of capacity to demand. Return visits to ED and evaluation of patient satisfaction with virtual care were used as outcome measures. Results: Patients referred to the rapid response pathway were seen in a shorter time than had previously been the case. Fewer patients returned to the ED on multiple occasions. Conclusions: Development of systems for categorizing patient risk levels, development of a virtual rapid response pathway, and flexing capacity to meet demand has enabled flexible rapid response to high needs patients.