Helping to enhance the behavioral health experience for ED patients and staff
Challenges in delivery of behavioral health care have been evident for decades. Millions of patients with mental health issues are underserved due to the lack of outpatient resources and inpatient treatment options available to them.1 For these patients, a visit to the emergency department may be the only option when crisis strikes. Unfortunately, many EDs are not well equipped to handle them. Overtaxed facilities and a shortage of specialists means managing and securing an inpatient bed for patients with behavioral health issues who require admission can take hours or days.1 To exacerbate the situation, new societal stressors are at play as a result of the COVID-19 pandemic and healthcare systems are already experiencing an influx of new patients with behavioral health issues.
What does the data show us? In many ED consulting engagements over the years, our consultants found that behavioral health issues were often of significant concern. Frequently, patients present with comorbidities such as alcohol and drugs/opioid misuse, and exhibit symptoms such as depression, anxiety and suicidality. In fact, the CDC suggests that from 1999 to 2017, the age-adjusted suicide rate has increased by 33% and is the second leading cause of death for ages 10–34.2 The increase in patients with behavioral health issues who visit an ED is due, in part, to the lack of other care options for them in their community.
From 1999 to 2017:
33%
increase
in the age-adjusted suicide rate.2
2nd
leading cause
of death for ages 10-34 is suicide.2
How do behavioral health patients impact the ED workflow? Emergency departments were not designed for long-term patient stays, but rather for rapid triage, stabilization and turnover. Additionally, there are safety concerns for patients with behavioral health issues in the ED environment, which pose a significant health risk. All those who seek help in the ED for behavioral health issues create a substantially negative impact on workflow. Long visits keep other patients from moving through and require a unique set of care resources. Behavioral health patients are often held in the ED for various reasons.
Our unique approach A review of behavioral health policies and procedures is done to identify relevance and alignment with best practices and regulatory guidance. A secondary emphasis should be placed on establishing and reinforcing communication with local community behavioral health resources. Our consultants have also identified the need for targeted behavioral health education for ED nursing staff and providers. If you’d liked to learn more about how our consultants help identify opportunities for improved efficiency and an enhanced ED experience for both staff and patients with behavioral health issues, download the white paper or contact us today!
1 Zink Anne, Mental health patients, with nowhere else to go, are overwhelming emergency departments, statnews.com, October 18, 2018, www.statnews.com/2018/10/18/mental-health-care-emergency-departments/ 2 Hedegaard Holly, M.D., Curtin Sally C., M.A., et. al., Suicide Mortality in the United States, 1999-2017, NCHS Data Brief No. 330, November 2018 www.cdc.gov/nchs/products/databriefs/db330.htm
Meet our team
Beth Fuller, DNP, RN, CEN, CCRN, CFRN Consulting Principal
Beth brings 30+ years of emergency, ICU, and critical care transport leadership in academic medical centers and community hospitals. She has helped increase efficiency and reduce cost while improving patient satisfaction and employee engagement.
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