PROJECT SUMMARY Most emergency departments (ED) in the United States are poorly designed, organized and equipped to provide safe and effective care for children with mental and behavioral health (MBH) conditions. Safety concerns for children with MBH conditions in the ED include delays in care, lack of appropriate psychiatric consults during visits, patient self-harm, harm against others or the environment, and involuntary restraint use resulting in patient and staff injury. A systems approach is needed to address the many latent conditions in the ED that impact MBH patient and provider safety. The purpose of the proposed ‘Realizing Improved Patient Care through Human- centered Design for Pediatric mental and behavioral health in the Emergency Department (RIPCHD.PED)’ patient safety learning lab (PSLL) is to develop and implement pediatric MBH health work systems in the ED that promote safe, efficient and effective care by minimizing unnecessary stressors for patients while also improving provider well-being. This PSLL will include a focus on the needs of children and their caregivers from minority communities in order to address disparities in MBH care in the ED. Further, the PSLL will focus on rural and urban EDs to ensure that proposed solutions address a range of resource constraints typically found in EDs across the US. A multidisciplinary team from Clemson University, Prisma Health and University of South Carolina School of Medicine will collaborate using a systems engineering approach involving in-depth problem analysis, design, development, implementation and evaluation. The specific aims of this project include, Aim 1: Use systems engineering methods to develop a shared in-depth understanding of the work system facilitators and barriers involved in the pediatric MBH ED caregiving workflow, Aim 2: Design and develop human-centered work systems for pediatric MBH patients in the ED that will improve access to timely MBH care, reduce adverse events and improve efficiency for ED healthcare providers and Aim 3: Integrate, implement and evaluate innovative interventions within pediatric MBH work systems in the ED that will improve outcomes for ED patients and healthcare providers. The team will use a range of methods including workflow analysis, journey mapping and space syntax analysis to understand barriers and facilitators and identify opportunities for improvement. An iterative design process will be used to design and develop solutions related to the physical environment, tools and technology and tasks and workflow. This PSLL strongly aligns with AHRQs mission by focusing on safety, quality, equity and access to appropriate mental health care for children with mental and behavioral health conditions. The project will support AHRQ’s strategic focus on children as a priority population by contributing to all 6 goals outlined in AHRQ’s strategic plan. Further, the PSLL will include a focus on underserved rural populations as well as children ...