2026-10-11T22:37:12Z https://api.figshare.com/v2/oai

oai:figshare.com:article/34046232 2026-10-01T14:14:45Z category_7 category_21 category_45 category_734 category_122 category_132 portal_87 item_type_6 month_year_10_2026

Simulation-based evaluation of alternative care pathways and capacity configurations in pediatric mental health emergency care Farzad Zeinali (25156896) Kevin Taaffe (10347094) Samuel Nelson Koscelny (25156899) David Neyens (16807929) Devi Soman (25156902) Anjali Joseph (5362937) Ann Dietrich (23034280) Medicine Biotechnology Sociology Biological Sciences not elsewhere classified Mental Health Infectious Diseases Pediatric mental and behavioral health emergency department crowding discrete-event simulation metamodeling capacity planning workflow redesign <p>Pediatric mental and behavioral health visits place growing pressure on emergency departments, where long evaluation times, disposition delays, and extended stays while waiting for placement or discharge increase crowding and resource strain.</p> <p>This study evaluated how alternative care pathways and capacity configurations are likely to affect pediatric emergency department performance for mental and behavioral health care.</p> <p>We developed a discrete-event simulation model of a pediatric emergency department using electronic medical record data, clinician input, and observed workflow. The model tested five scenario groups: psychiatric emergency unit routing, patient volume growth, disposition-to-departure delay, mental and behavioral health case-mix, and psychiatrist coverage.</p> <p>In the simulated emergency department, psychiatric emergency unit routing reduced time to psychiatric evaluation and space utilization. Reducing disposition-to-departure delays produced the largest improvements in throughput and space utilization, whereas expanded psychiatrist coverage primarily improved outcomes for mental and behavioral health patients, especially length of stay and time to disposition. Varying the patients case-mix had smaller effects within the tested range.</p> <p>Interventions should be matched to the bottlenecks. Psychiatric emergency unit routing may ease space constraints, psychiatrist coverage may reduce delays for mental and behavioral health patients, and shorter disposition delays may improve throughput.</p> 2026-10-01T14:14:45Z Text Journal contribution 10.6084/m9.figshare.34046232.v1 https://figshare.com/articles/journal_contribution/Simulation-based_evaluation_of_alternative_care_pathways_and_capacity_configurations_in_pediatric_mental_health_emergency_care/34046232 CC BY 4.0