Reducing Pediatric Mental Health Readmissions at Dayton Children’s

Summary

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Becker’s Healthcare Podcast

Reducing Pediatric Mental Health Readmissions at Dayton Children’s

Date: January 31, 2026
Host: Chris Sosa (A)
Guests: Dr. Kelly Sandberg (B), Dr. Katie Winner (C)

Overview

This episode explores how Dayton Children’s Hospital has tackled the challenge of pediatric mental health readmissions through strategic quality improvement initiatives since launching their inpatient mental health unit in 2019. Dr. Kelly Sandberg, Chief Medical Quality Officer, and Dr. Katie Winner, Chief of Psychiatry, share specific interventions, partnerships, and system-wide culture shifts that have driven measurable improvements—and offer practical advice to other health systems pursuing similar goals.

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Key Discussion Points & Insights

1. Background & Motivations

• Dayton Children’s Inpatient Mental Health Launch:
  • Inpatient unit opened in 2019.
  • Identified a need to address frequent readmissions—children returning due to unmet needs from initial admissions.
• Leadership Roles:
  • Dr. Sandberg provided quality improvement infrastructure.
  • Dr. Winner led clinical psychiatry and inpatient unit operations.

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2. Four Pillars for Reducing Readmissions

([03:24]–[04:04]; [05:15]–[07:00])

a. Individualized Readmission Programming

• Standard hospital programming was “like Groundhog Day”—repeating the same groups for each patient, regardless of needs.
• New strategy: Personalize plans, especially for returning patients, by asking:
  • What didn’t we address last time?
  • How can we adjust interventions to avoid repetition and improve outcomes?

“How do we make changes so that we're not doing the same thing over and over again, expecting different outcomes?”
— Dr. Katie Winner [03:04]

b. Follow-up Phone Calls

• Recognized difficulty for families to absorb all discharge info in crisis.
• Started calls within 24–72 hours post-discharge to:
  • Review and reinforce instructions.
  • Troubleshoot barriers (e.g., medication acquisition, appointments).
  • Prevent new crises by early intervention.
• Recently expanded calls to patients seen in the crisis center (psychiatric ER), most of whom discharge to home.

c. Conflict Management in Group Therapy

• Data revealed many readmissions tied to unresolved conflict at home, school, or among peers.
• Added structured conflict management content to all group therapy:
  • Communication, empathy, anger management skills for every patient.

d. Standardized Readmission Checklist

• Created to ensure all patients—regardless of treatment team—receive the same comprehensive aftercare options.
• Increased consistency and equity in discharge planning.

“It was really just a way to standardize what we were doing and make sure that no matter who you got assigned to your treatment team, you got the same options for aftercare available to you.”
— Dr. Katie Winner [03:56]

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3. Building & Scaling the Program

([04:22]–[08:37])

a. Learning from Peers

• Extensive collaboration with other Ohio pediatric hospitals; observed and adapted effective practices from others.

“We leaned very heavily on others’ learnings and trying to make the best program that we could make.”
— Dr. Katie Winner [04:50]

b. Systematic Expansion

• Initiatives like follow-up calls scaled across all Dayton Children’s departments.
• Enhanced data monitoring (dashboards), standardized practices for scalability, and ensured intervention “fidelity” as capacity grows (e.g., expansion from 24 to 48 beds).
• Strong sense of cross-discipline and community collaboration, including ongoing work with social determinants of health.

c. Operational Improvements & Culture

• Quality improvement tools now routine in mental health leadership and daily practice.

“It's not difficult to put quality improvement into pretty much every practice, routine practices.”
— Dr. Katie Winner [06:26]

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4. Patient & Family Feedback

([08:37]–[09:54])

• Positive feedback specifically about post-discharge calls:
  • Families appreciate the sense of “wraparound” support.
  • Reinforces that program changes make a meaningful difference for patients.

“They felt so much wraparound from our team that they were calling just to check in on their child and to make sure that they really had the tools available to them…”
— Dr. Katie Winner [09:26]

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5. Advice for Other Organizations

([10:12]–[13:34])

Dr. Kelly Sandberg’s Advice:

• Center Frontline Voices: Listen to doctors, nurses, therapists, and community workers for real-world challenges and solutions.
• Involve Non-Subject-Matter Experts: Invite process or quality experts to help analyze issues “from the outside.”
• Collaborate Widely: Engage other hospitals and community organizations (e.g., social services, government) to understand shared challenges.
  • Especially important with mental health under-resourcing and legislative complexities.

“Finding the key stakeholders in the community... those key stakeholders in the community could also include, you know, organizations that support homelessness or group homes, or seeing how, you know, and understanding what their challenges are so that we could better, you know, work together for the kids.”
— Dr. Kelly Sandberg [11:56]

Dr. Katie Winner’s Advice:

• Just Start—Small Steps Matter: Jump in, act on passion for improving care, even if resources are limited.
• Seek Mentorship: Find champions within the organization (“Kelly has been the cheerleader in this,” she notes).
• Use Data and Make Incremental Changes: Small interventions (like follow-up calls) don’t demand big budgets but can have a significant impact.

“There are small changes, things like a phone call, that don't take a lot of resources, that you can make a difference.”
— Dr. Katie Winner [13:18]

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Notable Quotes & Memorable Moments

• “What we found was conflict… so we added conflict management into all of our groups for every child.” — Dr. Katie Winner [03:46]
• “It has now become part of our leadership on the mental health unit, where we use things like the tools we had, checklists, standardizations, we built dashboards.” — Dr. Katie Winner [06:32]
• “If we've been successful, then we should be able to help the community by expanding, you know, that resource as well as offering community additional resources with respect to mental health and starting to tackle some of the social drivers of health.” — Dr. Kelly Sandberg [07:43]
• “Sometimes just jumping in, finding something that you're passionate about, and then finding a mentor.” — Dr. Katie Winner [12:41]

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Timestamps for Key Segments

• 00:00–01:03 | Host and guest introductions
• 01:24–04:04 | Four key readmission reduction initiatives described
• 04:22–05:15 | Collaborating and learning from other hospitals
• 05:15–08:37 | Building on success, scaling up, and operational improvements
• 08:37–09:54 | Positive patient/family feedback on programs
• 10:12–13:34 | Advice for other health systems

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Conclusion

Dayton Children’s success in reducing pediatric mental health readmissions is rooted in collaborative, data-driven quality improvement, practical individualized interventions, and a commitment to ongoing learning and expansion. The episode’s insights provide a blueprint for any healthcare team working to tackle complex, entrenched challenges—emphasizing teamwork, community engagement, and the potency of even simple interventions.

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Transcript

[A]

Welcome to the Becker's Healthcare Podcast. I'm Chris Sosa, your host, and I'm thrilled to be joined today by Dr. Kelly Sandberg, Chief Medical Quality Officer and a pediatric gastroenterologist at Dayton Children's, and his colleague, Dr. Katie Winter, Division Chief of Psychiatry at Dayton Children's. Kelly and Katie, thank you for joining us today.

[B]

Pleasure to be here.

[C]

Thank you.

[A]

Wonderful. So for those in our audience who are maybe not familiar, could you please introduce yourselves and give us a little bit about your background? Kelly, let's start with you.

[B]

Hi, I'm Kelly Sandberg. I've been a quality officer at Dayton Children's for the last almost 12 years now. I've been involved in developing some of the infrastructure for quality improvement, process improvement, and quality assurance, and currently developing an institute of quality and safety.

[A]

And Katie, great.

[C]

Hi. Thank you so much for having us. My name is Katie Winner. I'm the chief of Psychiatry here at Dayton Children's. My training is primarily in child and adolescent psychiatry and then also adult psychiatry, and most my clinical time is spent on the inpatient mental health unit.

[A]

Excellent. Thank you for sharing that, Kelly and Katie. So we have you on the podcast today to discuss everything. Well, maybe not everything, but the important things. Most important things Dayton Children's is doing in reducing mental health readmissions. So there are a lot of different ways we can go, but let's just start with what initiatives on that front have been successful. Kelly or Katie, take it away.

[C]

All right. So we have done a lot here at Dayton Children's. Things have really changed in the last. Actually since 2019, that is when we opened our inpatient unit. And in that time, we realized pretty quickly that we did have a problem with the remissions and kids kind of coming back and not getting what they needed out of the first time around. And so we actually did publish a paper looking at some of our initiatives that we did in quality improvement on the unit. And so some of the things that we did here were re admission programming. So most inpatient units will do the same programming kind of over and over. We're like Groundhog Day. You wake up, you go to groups, you do the same kind of groups. The next day, you wake up and do groups. Maybe a little bit different, but similar topics. So what we looked at was trying to come up with a more individualized plan for the kids that came back to us to really be able to better understand what didn't hit the mark. What problems did we not address last time they were here? And then how do we make changes so that we're not doing the same thing over and over again, expecting different outcomes. One of the other initiatives that we looked at were follow up phone calls. So this is something that is pretty simple, but when families are here on our unit or in any hospital setting, they're in crisis. And so it is very challenging for them to be able to absorb all the information that and everything that's going on around them. So what we started doing was when a family leaves, we try to give them a call anytime between 24 hours or 72 hours after they leave, just to review how, you know, the discharge information that they have. Can you make the follow up appointments? Were you able to get your medications? Just to problem solve, to make sure there are no issues that we might be able to address before another crisis appears. We also looked at our group structure itself. So part of our quality improvement was collecting data of why are these kids coming in? And what we found was conflict. There was conflict at home, there was conflict at school, there was conflict with peers. Teachers and kids did not have the tools that they needed to be able to deal with that conflict. So we added conflict management into all of our groups for every child to ensure that they had the communication skills, the empathy and anger management to try to better deal with what was going on in their lives. And then the last one that we really looked at was a readmission checklist. And this was really just a way to standardize what we were doing and make sure that no matter who you got assigned to your treatment team, you got the same options for aftercare available to you.

[A]

Katie, thank you for taking us through all of that. And so I have a follow up question on that. Just given where you started in 2019, was there a certain model from another department or the health system hospital, anything like that that you look to or tell us a little bit about how you built that program with those four steps that you mentioned?

[C]

Yeah. So I will say our collaboration within mental health, we are a small group of mental health providers across the country. And so there are children's hospital collaboratives that we get together with Ohio is wonderful in that we have five pediatric hospitals that we talk to on a pretty regular basis about what they're experiencing, how they did things. And so we, we went to a lot of these hospitals, we observed what they were doing, we reached out, we asked questions, and so we leaned very heavily on others learnings and trying to make the best program that we could make.

[A]

Makes total sense. Kelly. Katie, so next question I have for you is now that you've come as far as you have, how do you think Dayton Children's is going to be able to build on the success that you've had?

[C]

So, obviously, as I mentioned, we started this back in 2019, and it has been a process. The world has changed quite a bit in that time period. Our families have changed what the needs of the kids in our community have changed, and then the resources have also changed. So despite that, we are still doing pretty much every one of those initiatives, but we've expanded them. And so I'll take the phone calls, for instance. The phone calls. We started off on our unit, but now we do them throughout all of pretty much Dayton Children's. But one of the places that we really expanded to, first off, was our crisis center. And our crisis center is kind of like a psychiatric emergency room where two thirds of those kids actually go home. And so we are now calling them to make sure that they understand what discharge instructions, making sure that they're able to get into those providers so that they're not into another crisis. As I already mentioned, the collaboration piece is huge. We have been working with all of the Ohio hospitals on, you know, how do we continue to move forward and make sure that we are taking ideas and sharing ideas when it works. And then I will say, the other piece of this project that I feel like was really just eye opening was that it's not difficult to put quality improvement into pretty much every practice, routine practices. So it has now become part of our leadership on the mental health unit, where we use things like the tools we had, checklists, standardizations, we built dashboards. That way we can monitor and make sure we're running an efficient system that is providing the care that we need to provide.

[B]

Chris, another thing, as we're talking about building on success, you know, Katie has talked a lot about inpatient, and she just mentioned the crisis center just a second ago. But she, of course, is in charge of a lot more than just those two areas, as she does intensive outpatient. They have an outpatient day treatment program. They have counseling services. They have other things. So part of the reason why there's a broader system and a broader support in place that does support the work that's going on in both the crisis center and the inpatient unit. I think also that. And Katie, correct me if I'm speaking out of turn here, but there are plans to expand the mental beds. And so, you know, if we've been successful, then we should be able to help the community by expanding, you know, that resource as well as offering community additional resources with respect to mental health and starting to tackle some of the social drivers of health.

[C]

Yes, I agree that we have been able to expand and I don't want to say that every part of it was easy, but the actual patient care piece of it, the how to make sure that we are doing the same things in one location, location or with 24 beds versus 48 beds once we get there, I feel because we have become more efficient, it's become an easier system so that expansion has not been taxing on the teams. It's been easier to ensure that we are doing, you know, the same thing and that we have fidelity in what we're doing.

[A]

So I very much appreciate you qualifying and clarifying that, Katie. I'm sure. Thankfully, I don't think our listeners hear this and think, oh, this was easy. I think they understand very much so that any part of the job that you both are doing and others in your position are doing is very difficult. But I do certainly there's much to be said for the way you laid it out. Katie, I did want to follow up with you on something. So obviously no one can monitor all the phone calls that are happening between the two of you. But when you're taking in the feedback at Dayton Children's, what have you heard from patients that says to you, hey, this is really working for us and for them more importantly.

[C]

So I will say just today I had been reviewing. We do patients can review us and give us scores. And one of the comments actually was about the phone calls and how they felt so much wraparound from our team that they were calling just to check in on their child and to make sure that they really had the tools available to them that they needed. And so it was really nice to just kind of see that full circle circle that what we're doing does matter to the families, no doubt.

[A]

No. That's wonderful to hear. Lastly, I simply want to ask you both, just given your experience now since 2019 and stretching back further, if you prefer, what advice do you have for other health systems, other organizations who are looking to launch similar initiatives? So, Kelly, let's start with you there.

[B]

I think from a system standpoint, especially from the mental health standpoint, objectively listening to frontline leaders, and in this case it's not just doctors and nurses, but it's also the therapists and the community health workers and others to understand kind of the pain points and understand what it is that we're trying to do. And then at some point along the Way, I'm not a mental health provider, but yet I can serve as, as a sounding board and someone to check assumptions against. So Katie had mentioned, you know, something about conflict management that was not initially inherent until we had some robust back and forth discussions and questions and answers. And so having kind of someone who's not necessarily a subject matter expertise, but perhaps, you know, an expert in quality improvement or process improvement or safety can be really helpful. I think also finding the key stakeholders in the community, whether they be from other surrounding hospitals in the community or as Katie has mentioned, you know, the children's hospitals have a lot of great collaboratives. You know, a lot of us are dealing with the same challenges and the same restraints and so just understanding what others are doing and listening and agreeing that we're here to take care of, you know, patients, take care of kids. Those, you know, key stakeholders in the community could also include, you know, organizations that support homelessness or group homes, or seeing how, you know, and understanding what their challenges are so that we could better, you know, work together for the kids. And then finally, you know, working with appropriate government leaders to ensure that they understand the realities of providing care in 2026. It's an ever changing landscape. And if they, you know, if the decision makers in government don't have a clear line of sight into what's going on, especially in the mental health spaces, we're really kind of a 2 hit on that. Where we're first hit from, you know, not having the needed resources, but also not having the understanding when legislation is brought forward makes a lot of sense.

[A]

Kelly, thank you for laying out all those steps from the operational standpoint. It's very, very helpful. Katie, I'm looking forward to hearing what you add to this as well.

[C]

Yeah, I feel like my answer to kind of how to give advice to this is probably very simple. It's sometimes just jumping in, finding something that you're passionate about, and then finding a mentor. So Kelly was the mentor in this. Kelly has been the cheerleader in this. Despite not being a mental health, you know, practitioner, he has encouraged us to really, you know, jump in, look at the data and really get together and think of what can we do. As he mentioned, resources aren't always available, but there are small changes, things like a phone call that don't take a lot of resources that you can make a difference. So I just encourage people to really just think about what problems they feel like they have in the system and see how, you know, even that small change might actually make a big impact.

[A]

Excellent. Advice to be sure no one can do any of this all by themselves. And clearly you guys have gotten a long way looking not only to each other, but other people who have been very helpful. Kelly, Katie, thank you so much for being on the podcast today.

[B]

Thank you very much, Chris. It's been a pleasure.

[C]

Thank you.