BackgroundMental health problems are increasingly common among children and young people (CYP) with 1 in 8 reporting symptoms.1Our service experienced 3 presentations per week within 2016 which further increased by 60% this year. From doorway to discharge each patient will see 7 different healthcare professionals. This may result in frustration at perceived lack of communication between staff, lack of knowledge2and need to repeat their story.AimsCreate a multi-disciplinary mental health pro-forma for CYP presenting to hospital with mental health difficulties.Assist staff to complete appropriate, informed assessments.Improve patient experience by reducing need for story repetition.MethodsPlan:2 independent retrospective case-note analyses of 27 presentations to the Emergency Department (ED) over a 4 month period of patients aged between 14 and 15, and 24 admissions to the ward over a 3 month period of patients aged under 16.Do:Implemented a pro-forma encompassing the patient journey including key aspects identified for improvement from data analysis; risk assessment, safeguarding, physical and mental state examination (MSE).Study: Second data-analysis followed a 6 week pilot period. A further retrospective case-note analysis of 19 admissions to the ward via the ED.ResultsWithin ED there was improvement regarding risk assessment (92.9% vs 10%), safeguarding (100% vs 52.9%) and MSE (92.9% vs 51.9%).Ward data demonstrated a lack of engagement with the pro-forma, no change to those fully completing risk assessment (0%) and deterioration in MSE (57% vs 35.7%) and physical examination (70% vs 57.1%).Discussion and future directionThe mental health pro-forma resulted in clear improvement in outcomes within ED assessments across many aspects. These improvements may be replicated on the wards by increasing staff engagement with the pro-forma. Suggestions to achieve this aim, as well as other improvements, make up the ‘act’ aspect of our PDSA cycle:Abstract G74 Figure 1Page 1 and 2 of the paediatric mental health admission documentMulti-disciplinary education on mental health presentations and use of pro-forma.Pro-forma colour coding according to discipline for clearer access.Patient experience analysis.Further data analysis is planned for early 2018.