Seattle Children’s Emergency Department and Hospital Capacity Updates

Code Yellow for Mental Health ED Patient Surge Deactivated

From: Dr. Ruth McDonald, VP and Associate Chief Medical Officer (Hospital Operations) and Chief Medical Operations Officer; Bonnie Fryzlewicz, SVP and Chief Nursing Officer; Dr. Elaine Albert, Medical Director, Inpatient Access; Andrew Mullenix, Senior Director, Care Management and Patient Flow; and Laura Knapp, VP, Mental and Behavioral Health

Effective December 20, Seattle Children’s Code Yellow for Mental Health ED Patient Surge was deactivated. During the five weeks the Code Yellow was activated we made significant progress on the four key objectives identified at the start of the surge: ensuring staff and patient safety, providing excellent mental health care, maximizing the use of Psychiatry and Behavioral Medicine Unit (PBMU) and minimize boarding in alternate spaces, and advocating for resources outside the hospital. As a result of the improvements made during the Code Yellow, we are better positioned to meet future surges so we can care for every patient who needs us.

Our work will continue as open projects will transition to our internal Mental and Behavioral Health Task Force and operational leaders. The Incident Command team will remain in place, continue to monitor the situation, and assist when needed to ensure key work is progressing and issues are addressed in a timely manner.

It is important to note that though the Code Yellow has been deactivated, Seattle Children’s continues to see high numbers of pediatric patients with mental and behavioral health emergencies who require care in our Emergency Department and/or psychiatry inpatient units.

How You Can Help

1. Please continue to identify and manage lower-acuity complaints in outpatient settings, including urgent care, to help maintain ED capacity for higher-acuity concerns. Please see our Healthcare Professionals site for Resources for Community Providers.
2. Before sending your patient to the ED, contact our Mission Control team with as much notice as possible at 206-987-8899. This helps us plan for your patient’s arrival. In appropriate instances, we may be able to directly admit your patient to the hospital or arrange an urgent ambulatory clinic visit in lieu of an ED visit.
3. Please be aware that our inpatient PBMU has limited capacity for new patients. At this time, we are referring pediatric patients requiring psychiatric inpatient admission to appropriate facilities in Washington State, as needed.
4. Help set realistic expectations about an ED visit and/or inpatient admission with children, families, and partners.
   • An ED visit for mental or behavioral health typically involves an evaluation to determine if the child needs an inpatient psychiatric admission or is appropriate to discharge home. Patients and families should be prepared for potentially longer wait times.
   • As noted earlier, referrals to the PBMU will experience significant wait times and may not result in admission; we are asking all external partners to consider referring patients who need inpatient admission to all appropriate inpatient pediatric psychiatric facilities in Washington and consistently re-assess need for inpatient admission.
   • Patients seen in our ED who need inpatient psychiatric admission will be referred to all appropriate inpatient pediatric psychiatric facilities in Washington.
   • An inpatient psychiatric admission is typically 5 to 10 days and focused on acute crisis stabilization. It is not a long-term placement.