Service evaluation and retrospective audit of electronic HEEADSSS (e-HEEADSSS) screening device in paediatric inpatient service in Western Australia

Chia Saw, Alide Smit, Desiree Silva, Max K. Bulsara, Edward Tam Thuong Tran Nguyen

Research output: Contribution to journalArticlepeer-review


The top causes of adolescents' mortality in Australia and worldwide are mostly preventable and many stem from psychosocial difficulties. The HEEADSSS screening is a widely accepted screening tool in assessing young people's psychosocial wellbeing. This retrospective audit was done to evaluate the service implementation of an electronic-HEEADSSS (e-HEEADSSS) screening system in a regional hospital's paediatric in-patient setting in Western Australia. The aim is to examine and compare the uptake rate of conventional HEEADSSS screening in 2018 and e-HEEADSSS screening in 2019, and to examine the relevant outcome and disclosure rate by the young person. This retrospective audit (pre-post cross sectional study) is reported using the STROBE guideline. It was done over two different time frames: Pre e-HEEADSSS implementation (September-December 2018) and Post e-HEEADSSS implementation (September-December 2019). Inclusion criteria includes: All paediatric inpatients aged 12-16 years old. Exclusion criteria includes: Admission under other disciplines or clinically unstable/unsuitable patients. The uptake rate of conventional-HEEADSSS (2018) in comparison to e-HEEADSSS screening (2019) was examined. Other relevant data was extracted and analysed. The sample size pre-implementation was 26 while post-implementation was 24. The uptake rate increased from 12% (conventional-HEEADSSS) to 54% (e-HEEADSSS), a 450% increment with the e-HEEADSSS system implementation (Fisher Exact Test, p=0.005). More than half of young people who completed their e-HEEADSSS screening had concerns/flags which required management by the clinicians. 86% of patients in the e-HEEADSSS group with concerns/flags were acted appropriately by the treating clinicians prior to discharge. The overall disclosure rate of e-HEEADSSS was 93% with highest disclosure rate for 'Drugs' domain. There is significant increase in uptake rate with high disclosure rate using e-HEEADSSS screening device when compared to conventional HEEADSSS screening in the paediatric in-patient setting. The e-HEEADSSS is a better screening tool for in-patient setting and should be implemented widely.

Original languageEnglish
JournalInternational Journal of Adolescent Medicine and Health
Publication statusE-pub ahead of print - 22 Sep 2020


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