HEARTSMAP is a psychosocial assessment tool developed by the Divisions of Pediatric Emergency Medicine and Pediatric Psychiatry at BC Children’s Hospital (BCCH). HEARTSMAP helps emergency department (ED) clinicians assess and manage children and youth presenting with mental health complaints (i.e. depression, anxiety, eating disorders, etc.). While originally developed for an emergency department setting, HEARTSMAP is now available to clinicians to use at their discretion in emergency departments outside of BC and in community settings where a psychosocial assessment is warranted.
HEARTSMAP is composed of 10 psychosocial domains:

• Home
• Education and activities
• Alcohol and drugs
• Relationships and bullying
• Thoughts and anxiety
• Safety
• sexual health
• Mood and function
• Abuse
• Professionals and resources

Each of these sections is allocated a score:

• 0 for no concerns
• 1 for mild concerns
• 2 for moderate concerns
• 3 for major concerns

Validated among ED clinicians at BCCH, HEARTSMAP is currently the psychosocial assessment tool used for all mental health presentations at the BCCH ED and many EDs throughout British Columbia.

HEARTSMAP is designed for ED clinicians such as physicians, nurse practitioners, registered nurses, social workers, etc. who typically assess and manage children/youth presenting to the department with mental health complaints. Registration to use HEARTSMAP is also available to medical trainees, such as medical students, residents, and subspecialty fellows. HEARTSMAP is not intended for general public use.

Registration is required for all users.

Recommendations for management range from emergent consultation with a mental healthcare provider prior to disposition decision to referrals to community mental health services such as crisis response teams, social workers, youth health specialists, substance abuse services/detoxification programs, or redirection to an established care team (if applicable).

Typically, an assessment using HEARTSMAP will take 10-30 minutes to complete; however, this will vary depending on how forthcoming the family is with providing information and your history taking style.

Yes. HEARTSMAP was piloted at the BC Children’s Hospital pediatric ED in September 2014. ED clinicians at BC Children’s Hospital provided feedback during this pilot period, allowing us to refine tool’s scoring criteria, provide additional sample interview questions, and adapt the user interface to improve user experience. HEARTSMAP has since been adopted as the standard psychosocial assessment tool used at the BC Children’s Hospital pediatric ED.

Yes. HEARTSMAP’s inter-user reliability was evaluated among pediatric ED clinicians locally at BC Children’s Hospital in 2014, and among ED clinicians in general EDs in 2016.

At BC Children’s Hospital, data from 104 ED mental health presentations was extracted to construct clinical narratives. A panel of ED clinician evaluators reviewed each of these narratives. The panel included: 2 pediatric emergency medicine physicians, 1 nurse practitioner, and 1 bedside nurse. The results below summarize the agreement among the clinician reviewers with regard to consulting psychiatry in the ED:

In addition, eleven ED clinicians from 5 health authorities – Provincial Health Services Authority, Providence Health Care, Vancouver Coastal Health, Fraser Health Authority, and Interior Health Authority validated the HEARTSMAP tool in 2016 (2). These ED clinicians, including physicians, social workers, and psychiatric liaison nurses, were asked to use the HEARTSMAP tool to evaluate 50 fictional narratives describing a variety of pediatric mental health cases. 

We report moderate to near excellent agreement, overall among clinicians for all 10 of the tool’s psychosocial sections (κ=0.43 to 0.93) and domain scores (κ=0.75 to 0.90), with acceptable agreement across all tool-triggered service recommendations (κ=0.36 to 0.65). Our findings show that HEARTSMAP may be reliably used by ED clinicians in assessing MH issues among youth. Results from this study will assist in informing the wider clinical implementation of HEARTSMAP as a standard assessment tool, in diverse emergency care settings.

1. Viera AJ, Garrett JM. Understanding Interobserver Agreement¿: The Kappa Statistic. Fam Med. 2005;37(5):360-363.
2. Virk, P., Stenstrom, R., & Doan, Q. (2018). Reliability testing of the HEARTSMAP psychosocial assessment tool for multidisciplinary use and in diverse emergency settings. Paediatrics & Child Health, 1–6. https://doi.org/10.1093/pch/pxy017

During our HEARTSMAP pilot implementation at BC Children’s Hospital, we prospectively enrolled 62 patients presenting with mental health concerns to determine whether the tool could correctly predict which patients required a psychiatric admission. During the pilot implementation, users were asked to user HEARTSMAP to guide their assessment; however, the patient’s ultimate disposition was at the ED clinician’s discretion. The results are summarized below:

HEARTSMAP had 100% sensitivity, correctly identifying all 13 patients that required a psychiatric admission. HEARTSMAP’s specificity was 32%, recommending discharge for 16 of the 49 patients that were ultimately sent home. Nevertheless, our initial results at BC Children’s demonstrated a trend toward reducing wait times and the odds of requesting a psychiatric consult as a result of implementing HEARTSMAP.

HEARTSMAP is designed for clinicians such as physicians, nurse practitioners, registered nurses, social workers, etc. who typically assess and manage children/youth presenting to the emergency department or clinics with mental health complaints. Registration to use HEARTSMAP is also available to medical trainees, such as medical students, residents, and subspecialty fellows. HEARTSMAP is not intended for general public use.
Registration is required for all users.

In order to register, you will need to provide your name, work email, setting where Open HEARTSMAP will be primarily used, clinician type, and location.

No. HEARTSMAP is free for all registered users.

Yes. You can select “Save & Return Later” at the bottom of the training case page. You will then be provided with a return link for you to copy and save or email to yourself. This link will expire after 30 days.

An email containing your username and temporary password will be sent to the email you used for registration. You will be prompted to change your temporary password when you first login to use the tool.

Yes. The University of British Columbia Division of Continuing Professional Development (UBC CPD) is fully accredited by the Committee on Accreditation of Continuing Medical Education (CACME) to provide study credits for continuing medical education for physicians. This course has been reviewed and approved by the UBC Division of Continuing Professional Development. This Group Learning course meets the certification criteria of the College of Family Physicians of Canada and has been certified by UBC CPD for up to 1.5 Mainpro+ credits. This activity is an Accredited Self-Assessment Program eligible for up to 1.5 MOC Section 3 credits (1.5 credit hours) as defined by the Maintenance of Certification Program of The Royal College of Physicians & Surgeons of Canada. Remember to visit MAINPORT ePortfolio to record your learning and outcomes (credits are automatically tripled). Each physician should claim only those credits he/she actually spent in the activity.

In order to ensure complete documentation, each HEARTSMAP section requires:

• Assessment Notes
• A score (0-3)
• An indication of whether resources are in place to address any highlighted concerns (for scores 1+).

If these three sections are not sufficiently completed, you will not be able to continue on to the next HEARTSMAP section.

Patient care ultimately resides with the clinician. HEARTSMAP is intended to guide users through a psychosocial assessment, but should not replace clinical judgment. Your disposition plan does not have to match the HEARTSMAP tool’s recommendations for management. How clinicians decide to access services, or consult psychiatric specialties, is at the discretion of the clinician.

On the report page, select either “Download Report to Print” or “Email Report to Me”.

1. Download Report to Print: Once the report shows up, click the printer icon in the top right corner of the web page. Your device will need to be connected to a printer in order to print the report.
2. Email Report to Me: Once selected, the report will be emailed to the email address you used to register. Go to your email, open the report, and select Print from the File menu.

If you select “Download Report to Print”, but nothing downloads, your web browser’s pop-up blocker may be blocking it. To prevent this, click the pop-up blocker notification (found in or under the URL bar for most web browsers — see below) and select the allow pop-ups from tool.heartsmap.ca option.

Google Chrome:

Firefox:

Safari: Go to Preferences under the Safari menu. Click on Security, then uncheck the box that says Block pop-up windows.

Yes. To deactivate your account, please contact us at heartsmap@bcchr.ca.

After registering to use the tool, users can access the tool by logging in our homepage: https://openheartsmap.ca/. We recommend using the most current versions of the following browsers when accessing Open HEARTSMAP: Google Chrome, Mozilla Firefox, Safari, Internet Explorer 10

Your HEARTSMAP username is your work email address that you provided for registration.

If you forget your password, click the “Lost your password?” link below the Log In button on the homepage.

Once you enter your email address here and hit “Reset”, you will receive an email with directions to change your password.

To change your password, click the “Lost your password?” link below the Log In button on the homepage.

Once you enter your email address here and hit “Reset”, you will receive an email with directions to change your password.