WIHI - A Podcast from the Institute for Healthcare Improvement
Health & Fitness:Medicine
Scott Zeller, MD, Vice President of Acute Psychiatry, Vituity
Robin Henderson, PsyD, Chief Executive, Behavioral Health, Providence Medical Group Oregon and Clinical Liaison, Well Being Trust
Vera Feuer, MD, Director of Pediatric Emergency Psychiatry, Northwell Health
Mara Laderman, MPH, Director for Innovation, Institute for Healthcare Improvement (IHI)
For all that emergency departments (EDs) do to stabilize individuals and save lives, they’ve never been the ideal place for patients whose crises are related to behavioral health. EDs are designed to address the most urgent, sometimes life-threatening problems, and then discharge or transfer patients to the appropriate next level of care. If a psychiatric or addiction-related admission is needed, however, there may not be any beds. This often leads to boarding patients in the ED or adjacent hallways for hours, sometimes days.
In the US, many blame an underfunded mental health system for the shortage of inpatient beds and an inadequate supply of outpatient services that might help patients avoid going to the hospital altogether. Emergency department staff aren't any happier with the status quo. They have begun to look at how EDs might improve the overall care experience for behavioral health patients and contribute to continuity of care.
Promising new practices are being tested in nine hospitals participating in Integrating Behavioral Health in the Emergency Department and Upstream, an initiative led by IHI in partnership with Well Being Trust. Improvements these hospital EDs are testing include creating new lines of communication and care coordination, including post-discharge follow-up, with community-based services; standardizing and streamlining processes from intake to discharge for a range of mental health and substance abuse issues; working with both patients and their family members on self-management skills; and educating ED staff on behaviors consistent with a trauma-informed and empathetic culture.
We dicsussed these tests and innovations on the July 12 episode of WIHI: How to Build a Better Behavioral Health in the Emergency Department
WIHI: Reports from the Frontlines of Effective Crisis Management
WIHI: Primary Care's (New) Pressures and Possibilities
WIHI: Health Care’s Newest Improvers: Patient and Family Advisors
WIHI: The Newest Innovator on the Block: Center for Medicare and Medicaid Innovation
WIHI: A Legible Prescription for Health Care
WIHI: Alert to Change: New Models for Residency Work Hours
WIHI: The Power of Specialty Care – and the Necessity to Use It Wisely
WIHI: The Patient Activist
WIHI: Finding the Will to Bend the Cost Curve
WIHI: Nursing’s New Roadmap: Education, the Workforce, and Health Care Quality
WIHI: The Leaders Needed for the Changes Health Care Needs
WIHI: The Power to Detect and Reduce Harm: IHI’s Global Trigger Tool and Adverse Events in the US
WIHI: Reducing Readmissions, Restoring Revenues: Making Good Care Count
WIHI: The Buzz about Medical Training: It’s (Slowly) Changing
WIHI: Leaders Never Stop Learning
WIHI: Against All Odds: Maternal Survival in Ghana and the US
WIHI: Unprofessional Behavior Not Permitted Here
WIHI: The Image of Better (Radiation) Imaging Practices
WIHI: Learning by Data and by Doing: Low-Cost, High-Quality Health Care in America
WIHI: Coaching’s the Thing for Primary Care Practice
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