Date on Capstone

3-2026

Document Type

Capstone

Degree Name

D.S.W.

Cooperating University

University of Louisville

Degree Program

Social Work, D.S.W.

Committee Chair

Rhema, Susan

Committee Member

Winters, Andrew

Committee Member

Archuleta, Adrian

Committee Member

BrintzenhofeSzoc, Karlynn

Committee Member

Golder, Seana

Author's Keywords

Emergency department boarding; Behavioral health access; Digital referral platform; Health equity; Psychiatric crisis; Hospital social work

Abstract

Emergency Department Boarding for Psychiatric Care: The Effect of PointClickCare Integration

Abstract

For many individuals in psychiatric crisis, the emergency department has become the first place to seek help, highlighting gaps in how behavioral health care is accessed and coordinated. In Massachusetts, PointClickCare's Behavioral Health Treatment and Referral Platform (BH TRP) was implemented to centralize and streamline referrals between emergency departments and inpatient psychiatric facilities. This capstone evaluates whether implementation of the BH TRP was associated with changes in psychiatric boarding time at a community hospital emergency department. Using a mixed-methods program evaluation design, this study analyzed de-identified electronic medical record data for patients presenting with behavioral health needs before and after implementation of the platform and included qualitative interviews with crisis clinicians involved in the referral process. Boarding time decreased after implementation, suggesting the platform improved aspects of referral coordination. Disparities tied to insurance status and primary language persisted. Clinicians described the referral process as more efficient and transparent; however, they also noted that patients with more complex clinical and social needs often became increasingly difficult to place when not accepted early, resulting in longer boarding times. These findings suggest that while technology may streamline parts of the referral process, larger systemic issues continue to influence equitable access to inpatient psychiatric care.

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