Dr. Katherine A. Hinderer, Senior Nurse Scientist at Connecticut Children’s

Summary

Becker’s Healthcare Podcast: In-Depth Summary of Episode Featuring Dr. Katherine A. Hinderer

Release Date: July 14, 2025

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Introduction and Background

In this illuminating episode of the Becker’s Healthcare Podcast, host Laura Deardle welcomes Dr. Katherine A. Hinderer, the Senior Nurse Scientist at the Institute of Nursing Research and Evidence-Based Practice, and Associate Chair of Nursing Research at the Connecticut Children’s Research Institute. Dr. Hinderer shares her extensive career journey, transitioning from bedside nursing in adult health ICU to academia and ultimately to her current role, where she passionately integrates research with clinical practice to enhance pediatric care.

Dr. Hinderer (00:39): “One of the best parts about my job is working with clinical teachers, teams and especially I love working with nurses... to really support research questions that make a difference in the care of children and their families at the bedside.”

Challenges in Pediatric Mental Health

Dr. Hinderer delves into the pressing issues surrounding pediatric mental health, highlighting the pre-existing resource shortages that were exacerbated by the COVID-19 pandemic. She emphasizes the increased influx of children and adolescents presenting with mental and behavioral health concerns during the pandemic, underscoring the urgent need for effective interventions and resources.

Dr. Hinderer (03:02): “Even before the COVID pandemic started, pediatric mental health was facing significant challenges in terms of not having enough resources to really adequately care for kids and families of kids that have mental health and behavioral health concerns.”

Development of the Emergency Behavioral Health Assessment Tool (EBAT)

The conversation transitions to Dr. Hinderer’s pivotal role in developing the Emergency Behavioral Health Assessment Tool (EBAT), a comprehensive instrument designed to enhance the assessment and care of children with mental health issues in emergency settings. Spearheaded by Nurse Leader Ryan O’Donnell and a dedicated clinical nurse, the team rapidly developed EBAT in response to the escalating mental health crises during the pandemic.

Dr. Hinderer (05:30): “Our physician provider, who is Dr. Steve Rogers, likes to call it a vital signs for mental health. And it is kind of like that, but I look at it as a little more than that in that it's giving our nurses tools to help quantify what's going on with their patients and then help guide them in their practice.”

Impact and Results of EBAT

Dr. Hinderer outlines the multifaceted benefits of EBAT, including its ability to provide real-time assessments, guide tailored nursing interventions, and support leadership in resource allocation. Notably, the implementation of EBAT has led to a significant reduction in the use of restraints, fostering a safer and more supportive environment for young patients.

Dr. Hinderer (08:15): “One of the most amazing outcomes of this project is that we were really able to significantly drop the number [of restraints used].”

She further explains how EBAT allows for dynamic reassessment of patients’ mental health status, enabling timely adjustments in care strategies based on the evolving needs of each child.

Advice for Other Clinicians

When addressing clinicians facing similar challenges, Dr. Hinderer advises focusing on identifying and securing the necessary resources to support pediatric mental health effectively. She emphasizes the importance of data-driven advocacy, as demonstrated by EBAT’s role in justifying the need for specialized staff and training.

Dr. Hinderer (10:37): “Always focusing on what are the real resources you need and then trying to get those resources... our nursing leadership team to have the data to support the need for some of those things that they were able to get.”

Dr. Hinderer also shares exciting developments, including further validation studies funded by the Heilbrunnner Scholar Award from Rockefeller University, aimed at refining EBAT for broader application across other institutions.

Future Directions and Connecticut Children’s Initiatives

Looking ahead, Dr. Hinderer envisions a future where community-based resources minimize the necessity for emergency department visits due to mental health issues. She highlights Connecticut Children’s ongoing efforts, such as the recent establishment of a suicide prevention center and partnerships with state organizations to bolster youth mental health services.

Dr. Hinderer (13:16): “My dream is that we don't have to treat as many children in the emergency department with mental health concerns. I hope that... we'll be able to strengthen our community-based resources so that kids can get the care they need in their own communities, in their own homes.”

Dr. Hinderer articulates her commitment to reducing the marginalization of children with mental health conditions through improved care practices and research-driven interventions, ultimately striving for enhanced mental wellness and functional integration of youth within their communities and schools.

Conclusion

The episode concludes with Dr. Hinderer expressing her aspirations for the future of youth mental health care and acknowledging the collaborative efforts required to achieve systemic improvements. Host Laura Deardle commends Dr. Hinderer for her inspiring contributions and impactful research, emphasizing the significance of such initiatives in transforming pediatric healthcare.

Dr. Hinderer (15:14): “We’re just going to help improve the care of those kids so that they can get to where they need to be... towards mental wellness and to a place where they will be able to continue to function and live in their schools and their communities and not have to visit us.”

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Key Takeaways:

• Career Integration: Dr. Hinderer’s journey from bedside nursing to research highlights the critical role of nurse scientists in bridging clinical practice and academic research to enhance patient care.

• EBAT’s Innovation: The development and implementation of the Emergency Behavioral Health Assessment Tool represent a significant advancement in pediatric mental health care, providing a structured and dynamic approach to assessment and intervention.

• Impactful Outcomes: EBAT has not only improved the quality of care but also contributed to a reduction in the use of restraints, promoting a more compassionate and effective treatment environment for children.

• Future Vision: Dr. Hinderer advocates for strengthening community-based resources and reducing emergency department visits for mental health concerns, aiming for a holistic and preventive approach to youth mental health.

This episode serves as a compelling exploration of the challenges and innovations in pediatric mental health care, offering valuable insights and practical solutions for healthcare professionals striving to improve outcomes for young patients.

Transcript

[A]

This is Laura Deardle with the Beckless Healthcare Podcast. I'm thrilled today to be joined by Dr. Katie Hinderer, Senior Nurse Scientist at the Institute of Nursing Research and Evidence Based Practice, as well as Associate Chair of Nursing Research at the Connecticut Children's Research Institute. Dr. Hinderer, it's a pleasure to have you on the podcast today.

[B]

Thanks. I'm really excited to be here.

[A]

Absolutely. And I'm looking forward to connecting with you as well. I know we're going to go over some really important information here about pediatric mental health. So this is going to be a podcast that really touches on so many different aspects of care that are important to all communities. But before we dive in, I'm wondering, can you tell us a little bit more about yourself and your career journey?

[B]

Sure. So I am currently a nurse scientist in a pediatric health center at Connecticut Children's which is in Hartford, Connecticut. I started out my career as a nurse in actually adult health IC and worked at the bedside for a while before I realized that there were other things in my future. I was always really interested in education and research, so I shifted gears and went and taught at Salisbury University in their school of Nursing at Salisbury, Maryland for a while. While I was there, I had the unique opportunity to work with some of the nurses at one of the local hospitals in Salisbury and I really found myself enjoying that time connecting with the clinical nurses, talking to them about the real issues that were going on at the beds side and just being able to spend time with them and actually support them in research and evidence based practice that they were interested in doing. So as a result, I ended up transitioning my career again and was able to accept this position as a nurse scientist at Connecticut Children's and I've since been able to grow in that role as well. I think I like to say one of the best parts about my job is working with clinical teachers, teams and especially I love working with nurses of course, to really support research questions that make a difference in the care of children and their families at the bedside. So that's kind of what got me to where I am now. And I really love being a nurse and love working with nurses and particularly love being able to do research in the pediatric world.

[A]

That's amazing to hear and what a great journey that you had over time within the clinical space as well as leadership and research and more. It just really makes a big difference on the type of care that we're able to provide to especially pediatric patients now. I know we've recently done a lot of work around some pediatric mental health and behavioral health. And so I was wondering if you could tell us a little bit about that. And, you know, what really you're seeing out there in the space. What's top of mind is some of the biggest challenges that you're encountering.

[B]

Absolutely. So we know that even before the COVID pandemic started, Pediatric mental health was facing significant challenges in terms of not having enough resources to really adequately care for kids and families of kids that have mental health and behavioral health concerns. So leading up to the pandemic, we already were resource poor in this area as a country in general. Once Covid hit, we started to see really significant impacts in the mental health of everybody. But we were really specifically focused in on children and adolescents and even young adults that were presenting to our medical center with different mental and behavioral health concerns at the time. We were fortunate enough to receive some funding to start looking at better ways to be able to care for kids who are suffering from mental health and behavioral health concerns. So we initially wanted to look at how can the nurse at the bedside better assess a child that comes into the emergency department and better be able to tailor their care to make sure that the needs of that child and their family are being met to the the best of our ability. Obviously, we don't want children to have to come to the ER for mental health, but sometimes this happens. And at the time during the pandemic, we were seeing a lot of kids coming in with mental health chief complaints. As nurses, we really wanted to look at what we could do to improve practice. The great thing about the team that was built at the time Was that it was really led by our nurse manager of the emergency department, and also our senior director of emergency medicine. So we have a really nice interprofessional team that approached this care from a lot of different lenses. We also were able to take this work and develop a tool, which is what we kind of came up with as a result of this initial study. And the tool that we developed is called the emergency behavioral health assessment tool. The nice thing about the emergency behavioral mental health assessment tool, or as we lovingly call it, the ebat, is that it provides nurses with a nursing assessment instrument to help them sort of best categorize where the needs of the child are at the time. And then it also helps direct nurses towards what kinds of nursing interventions we can do to help support those children. It also allows for our leadership team to have a real time capture of what's going on in the unit as far as the children that have mental health concerns. And it also allows us an opportunity to help to make the case for resources we might need for the kids. So for example, if we have kids that need one to one observation and you need to have staff there to be able to sit with the children and watch them, this tool provides that kind of objective assessment of that so that they can really do those get those things that they need. Our physician provider, who is Dr. Steve Rogers, likes to call it a vital signs for mental health. And it is kind of like that, but I look at it as a little more than that in that it's giving our nurses tools to help quantify what's going on with their patients and then help guide them in their practice.

[A]

That's amazing and really helpful to understand the impact of what a tool like this can do in order to deliver the right care and make sure that the nurses have what they need in order to direct the patients and get them into the spaces they need to get in so that, you know, they're able to start whatever treatments they need or you know, really have that kind of like care that is so important to them. I'm curious, you know, in looking at this tool, how did you develop it, what was that process like? And then are there any results that you can share with us from how it's been working out so far? Sure.

[B]

So the tool was really, as I said, it was actually the brainchild of our nurse leader at the time, Ryan o', Donnell, and also one of the clinical nurses who was working primarily with this population. They decided we need to do this thing. And then this team organically came together and we just started plugging away at it. During the pandemic, fortunately or not fortunately, because things were escalating so quickly with pediatric mental health at that time, enabled us to be able to really hone in and focus on this product and get it done relatively quickly. I think some of the things and the good outcomes that we've seen from this tool are that it gives us a sort of ongoing ability to assess patients where they are at the very moment of care that you're with them. So for example, when kids typically present to the emergency department or any patient presents to the emergency department, they get a one time sort of assessment that gives the overall sort of level of acuity of the patient. But that is a static measure and it doesn't change. And we know with a lot of health conditions, but particularly with kids in mental health, that their condition can change a lot over the course of time. That they're maybe being seen in the emergency department. So this tool allows us that flexibility to be able to continue to reassess the patient and say, okay, well now their acuity is a little bit lower, so maybe they don't need the intense interventions that we were doing a little bit earlier, or maybe now their acuity is going up and they're, you know, getting upset or other things are happening. So we need to kind of intervene a little bit more with those kids. The other thing that we found in our own practice was that we were able to significantly reduce the amount of restraint use and the amount of other types of restraint devices on the kids who were in the mental health area. So what it did, I think, was allowed us to identify better ways to help kids who were struggling with mental health. And it allowed us more opportunity to be able to provide that one on one observation and allowed us to really back away from the use of as many restraints in the patients, which is always like a goal. We don't want to ever have to do that. And sometimes for safety, that's something that we have to do. But I think that that to me has been one of the most amazing outcome of this project is that we were really able to significantly drop that number.

[A]

That's amazing to hear. And you know, what a significant action to be able to take. And like you said, reducing that number of children restraints, I can imagine that makes a really big difference for those patients and their families as they're going through their care journeys with you. I'm curious, you know, for other clinicians out there in hospitals or systems that are experiencing similar challenges to what you have described at the beginning of our conversation, what can you they do to develop something similar or really be able to start moving in this direction of being able to understand patients better and then have a tool of their own that they can assess in real time.

[B]

So I think there were many things that we did as an organization at Connecticut Children's to better support pediatric mental health. That happened along with the development of the tool. As I said, with this tool we were able to quantify getting more resources that were tailored towards mental health. So we were able to hire more individuals who could sit with the patients. We were able to hire more nurses with specialized training. We were able to bring in some different training programs for our teams, which really I think helped. So I think as organizations are looking at this, always focusing on what are the real resources you need and then trying to get those resources, I think that this allowed our nursing leadership team to have the data to support the need for some of those things that they were able to get. We are currently working now. We have some new funding which is from the Heilbrunnner Scholar Award from Rockefeller University. And we're actually working to do some further validation testing of our tool over the course of the next year. We're going to be doing a study that's going to look at the tool itself. We're going to be doing some different types of statistical tests to see how well the tool is performing. And we hope to really be able to have a nice final product at the end of the year that we can share with other institutions. This, to me is really exciting because there really aren't a lot of tools out there that are like what we're, we're offering in our tool. And I think it's going to provide a nice way to, you know, say this is a good tool, it's reliable, it's valid, and it's something that can be used in other institutions as well. As a scientist, nobody ever likes to create their own measures. And especially the homegrown measure thing isn't always the best approach, even though sometimes people have to do that. But I think the work that we're going to be doing this year is even more exciting because we're going to be really trying to further support and make the best tool possible so that other institutions across the country can use this tool to support their own nursing practice.

[A]

I love that. Thank you so much for digging a little bit deeper there and explaining just everything that goes into developing a program and tool that's transformative for those youth mental health patients. Before we wrap up here, I wanted to get your thoughts on what's next. Where do you see the space of youth mental health headed and especially how are things changing at Connecticut Children's?

[B]

Of course. So as a nurse, I'm always a nurse first and then also as a scientist. My dream is that we don't have to treat as many children in the emergency department with mental health concerns. I hope that in the future the research we're doing and research that others are doing are going to help to decrease the need for kids to come to the emergency department when they're having mental health concerns. And I'm hoping that, you know, we'll be able to strengthen our community based resources so that kids can get the care they need in their own communities, in their own homes. That's kind of my dream for where youth mental health is going to go. It's probably going to take a lifetime to finish that work. But that's kind of what I think. At Connecticut Children's, I think we're continuing to really focus on a lot of different aspects of youth mental health. We've recently opened a suicide prevention center. We have a lot of other work being done in the mental health space, both in the emergency department and also on our inpatient side of care as well, and partnering with other institutions and organizations across the state to really help promote youth mental health. I'm hoping that, you know, as a nurse scientist, my impact on this research would be just to really improve the practice and the care that these kids receive. Because a lot of times, you know, kids can be very marginalized that have mental health conditions. Actually, anybody that has a mental health condition can be marginalized. A lot of people don't understand mental health conditions or have empathy for folks that have mental health conditions. And I'm hoping that through the work that we're doing, we're just going to help improve the care of those kids so that they can get to where they need to be so they can try to really get towards mental wellness and to a place where they will be able to continue to function and live in their schools and their communities and not have to visit us.

[A]

I love that. Dr. Hinderer, thank you so much for joining us on the podcast today. This has been such a fun conversation, really inspiring and informative, and I look forward to connecting with you again soon.

[B]

Thank you so much. It was great being here, too.