Organizational, Clinical, and Ethical Strategies to Develop Consultation/Liaison Services in a Pediatric Medical Setting: Implementation of a Universal Order Set

Objective : While numerous inpatient consultation-liaison (C/L) models of care exist within pediatric psychology, decisions about which framework best fits a particular medical system’s needs stem from several factors including patient populations served, volume of referrals, leadership structure(s), and staff resources. Additionally, service lines often change over time due to growth and changes in clinical care needs, requiring adjustment and development in the approach to and provision of clinical care from C/L teams. Therefore, novel clinical strategies and approaches to C/L practices and care models for pediatric psychologists within pediatric medical settings can support adaptation to these changing needs. Method : The current manuscript details the strategic growth of an existing C/L service line through use of a novel clinical strategy: implementation of a universal behavioral health consultation order (UBHCO) for all C/L behavioral health teams within a large children’s hospital setting. Results : In the current setting, the UBHCO facilitated (1) reduction in redundancy in behavioral health consultations, (2) improved operationalization of consultation questions, (3) streamlining referral pathways for medical colleagues, (4) increased number of consultations, (5) reduction in response time to complete consults, and (6) further updates to the practice model and team needs. Conclusions : The UBHCO allows for efficient behavioral health team triage, thereby supporting prompt responses and provision of coordinated, patient-centered care from the C/L psychology team. Programmatic and operational considerations, navigation of institutional context, clinical implementation and flow, collaboration among multidisciplinary behavioral health teams, incorporation of key ethical considerations, and future directions are described. Implications for Impact Statement Adopting a universal behavioral health consultation order offers a systems-level approach to optimizing inpatient consultation-liaison psychology services. By standardizing the referral process, this framework can remove traditional barriers to care, ensuring that behavioral health is included as a proactive standard of care for youth in inpatient medical settings. This approach ensures patients receive timely psychological consultation regardless of medical diagnosis, improving overall quality of pediatric inpatient care.