rapid access to psychiatric care creating a “safety net” for high risk patients while decreasing...
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Rapid Access to Psychiatric Care
Creating a “Safety Net” for High Risk Patients while decreasing Emergency Department Visits and Inpatient Admissions
Oakville Trafalgar Memorial Hospital- Halton Healthcare Services
NEXTHOME
Project Objective & Plan:
Objective: Provide patients with rapid access to Mental
Health and Concurrent Disorder Services, minimizing patients decompensation, unnecessary ED visits and inpatient admission.
Plan: Provide access to Psychiatric care within 7-days Allow access to Concurrent Disorder Services
within 2-4 days. Create a Concurrent Disorder Clinician role on
inpatient psychiatry. Develop plan within existing budget!
BACK NEXTHOME
Mental Health Urgent Care Clinic
Patients are seen, on average, within 7-days of their ED visit or inpatient discharge and provided up to 3 sessions to bridge them to appropriate services.
Outcome: During their involvement with the
UCC, out of 346 patients served in year 1, only 3% attended the ED and 4% were admitted.
There was a 69% decrease in ED visits when examining the 346 patients 3-months pre and post UCC involvement.
From 2008-09 to 2009-10 the program saw a decrease in early repeat ED visits for Mental Health by 1.2% and for Addictions by 1.9%.
0
100
200
300
400
PRE POST
419
2-YEAR ED COMPARATOR
3-mos Pre Post ED Visits
2008/2009 2009/20100.0%2.0%4.0%6.0%8.0%
10.0%12.0%14.0% 12.8%
11.6%
9.0%
7.1%
Mental Health Di...
0000Number of Participants1974
1831
364
240
BACK NEXTHOME
Bridges To Recovery Group
Developed an open ended group to allow for rapid access to Concurrent Disorders treatment.
The group is intended to (1) bridge clients to more intensive services and / or (2) to enhance current treatment received.
Outcome: Significant decrease over a 12-month period for ED visits
and inpatient admission during the time patients are engaged in the program.
Positive patient satisfaction results as they are now services by one team for Concurrent Disorders.
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
BACK NEXTHOME
Outcome:
Decrease in ED Visits &Inpatient Admissions
3 6 9 120
20406080
100120140
25 20 1889
17 125
PrePost
Months in Program
ED Visits
(31 Participants) (24 Participants) (17 Participants) (7 Participants)
Decrease%
64% 15% 33% 37%
51% 51% 51% 92%
BACK NEXTHOME
Concurrent Disorders Clinician on Inpatient Unit Revamped 1 nursing position to create a Concurrent
Disorder (CD) Clinician role to work along the interdisciplinary team on both the adult and child/ adolescent mental health inpatient units.
Goal: to engage patient in CD treatment at the time of their admission, considering the high relapse nature of the illness and enhance the opportunities to motivate patients in following treatment.
Developed CD Psychoeducational groups, which are delivered twice a week on the inpatient unit with other allied health staff.
BACK NEXTHOME
Outcome:
• Positive patient satisfaction resultsfrom the 346patients who have attend groups.
• A random sample of 21 participants showsa decrease of ED visits by 62% and a decrease of admissions by 86%, 3-month post discharge. 0
5
10
15
20
25
# Patients VisitedER 3-mos post
discharge
# Patients AdmittedIPS 3-mos post
discharge
3 Month post discharge for ED Visits /
Inpatients Readmits
Strong
ly Agr
ee
Agree
Undec
ided
Agree
Strong
ly Disa
gree
0
5
10
15
20
25
30
15
10
17
1 1
18
9
1
1311
19
8
19
8
2
Topic was relevant to patient needs
Facilitator was knowledgable
Enough time to discuss
Information discussed was understandable
Patient Satisfaction Survey
BACK NEXTHOME
Project Participants
Bridges to Recovery Group Angela Everest, OT, Jennifer Opper, RN,
Tammy Lawless, MSW
Concurrent Disorders Clinician Jennifer Folwer, RN, Erica Howard OTA
Shannan Fortier
Mental Health Urgent Care Clinic Dr. Jane Gilbert, Adult Psychiatrist
For Further Information, please contactVivian Demian, Program Director for Mental Health Oakville Trafalgar Memorial Hospital(905) 845-2571 ext 5640 - [email protected]
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