HALLMARK 485 POWERPOINT

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Nightingale College *

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485

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Medicine

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Apr 3, 2024

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pptx

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18

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PSYCH PATIENTS IN THE EMERGENCY ROOM Shelbie Bynum Nightingale College BSN 485 Capstone Leadership Anne Hammons MSN, RN, CNS December 3, 2023
INTRODUCTION Better resources for Psychiatrics Reducing ED crowding Supporting staff and patients Prioritizing safety
PURPOSE OF PROJECT Reduction on boarding times in the ER Psych patients are isolated for days Delayed treatment and rehospitalizations occur
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LITERATURE REVIEW Timestamps Identifying delays Telepsychiatr y
LITERATURE REVIEW CONTINUED Defining boarding times Outcomes of patients Safety risks
LITERATURE REVIEW CONTINUED Cost efficient Severe economic challenge Domino effect of the problem
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OUTCOMES Psych patients will be free of harm Psych evaluation within 1 hour of boarding Treatment will be given efficiently Follow up appointments after discharge Resources to support staff in ER
APPROACHES Agitation scale to guide treatment Support from psych specialists 24-hour assistance for evaluation and treatment
APPROACHES CONTINUED Patient unable to be educated Surveys to provide feedback Supporting staff members in their role
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BUDGET Budget Item Description Amount Needed Proposed Sources Personal computer Needed for research, creating surveys, assessing progress of project $0 Self paper Paper for surveys and printing multiple copies $0 Hospital Pens Filling out surveys and writing feedback of project $0 Staff, Self, Management Snacks, Chairs, Tables Setting up an area for staff and management to meet, discuss, and engage the project and its purpose. $50 per meeting. Two meetings for the planning and evaluation phase $100 total Hospital Two psychiatrists Two specialists in ED 24 hours a day. Night and days. Hourly wage per psychiatrist is on average in North Dakota $117/hr. For 12-hour shifts total for both would be $2,808/day Hospital
BUDGET CONTINUED INITIAL COST WILL BE LESS LONG-TERM ADDITIONAL PSYCHIATRISTS IS BIGGEST COST NEW SYSTEM WILL REDUCE READMISSION COST
STRATEGIES Telepsychiatry Observation section in ER. Creating a therapeutic environment
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STRATEGIES CONTINUED Limitations to strategies Burnout among staff Less psychiatric resources
RESULTS Anticipated 10% reduction in boarding times Education retention in patients Improved training in staff
MEASURING THE RESULTS TIMESTAMPS IN EHR FEEDBACK FROM STAFF NUMBER OF READMISSIONS
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CONCLUSION SLIDE Fewer physical morbidities in psych patients. Cost efficient Safe work practices among staff Reduces emergency workload
REFERENCE Barrick, L., Wu, D. T. Y., Frey, T., Shu, D., Abbu, R., Porter, S. C., & Overmann, K. M. (2021). Improving care delivery: location timestamps to enhance process measurement of a clinical workflow. Pediatric Quality & Safety, 6(5), e475. https://doi.org/10.1097/pq9.0000000000000475 Freeman, R. E., Boggs, K. M., Zachrison, K. S., Freid, R. D., Sullivan, A. F., Espinola, J. A., & Camargo, C. A. (2020). National study of telepsychiatry use in u.s. emergency departments. Psychiatric Services, 71(6), 540–546. https://doi.org/10.1176/appi.ps.201900237 Kelen, G. D., Wolfe, R., D’Onofrio, G., Mills, A. M., Dierks, D., Stern, S. A., Wadman, M. C., & Sokolove, P. E. (2021). Emergency department crowding: the canary in the healthcare system. NEJM Catalyst. https://catalyst.nejm.org/doi/full/10.1056/CAT.21.0217
REFERENCES CONTINUED Nordstrom, K., Berlin, J. S., Nash, S., Shah, S. B., Schmelzer, N. A., & Worley, L. L. (2019). Boarding of mentally ill patients in emergency departments: American Psychiatric Association Resource Document. Western Journal of Emergency Medicine, 20(5), 690–695. https://doi.org/10.5811/westjem.2019.6.42422 Stamy, C. D., Shane, D. M., Kannedy, L., Van Heukelom, P., Mohr, N. M., Tate, J., Montross, K., & Lee, S. (2020). Economic evaluation of the emergency department after implementation of an emergency psychiatric assessment, treatment, and healing unit. Academic Emergency Medicine, 28(1), 82–91. https://doi.org/10.1111/acem.14118 Yang, Y., & Hayes, J. A. (2020). Causes and consequences of burnout among mental health professionals: A practice-oriented review of recent empirical literature. Psychotherapy, 57(3), 426–436. https://doi.org/10.1037/pst0000317
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