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Boston, Mass. and Oakland, Calif., January 23—Today, a White Paper, providing actionable guidance for hospital emergency departments and their community partners to create a compassionate, seamless, and effective system of care that is respectful of and works with patients with mental health conditions and substance use disorders who present to the emergency department (ED), has been released by the Institute for Healthcare Improvement (IHI) and Well Being Trust (WBT).
The white paper, Improving Behavioral Health Care in the Emergency Department and Upstream, describes current gaps in care, tested improvements to close those gaps, and resources and tools that may provide additional support to ED care teams, patients, and their families.
To develop these solutions, IHI, in partnership with WBT, convened eight US hospitals in an 18-month learning community. By the end of the project, participants had tested strategies for improving patient outcomes and experiences of care, while decreasing avoidable repeat ED visits for individuals with mental health and substance use disorders who present to the ED. Additionally, some participants were able to reduce the ED length of stay, the number of patient-to-staff assaults, and the use of restraints.
“The experiences of these participating organizations demonstrate it is possible to improve the care, experience, and outcomes for these patients,” said Dr. Trissa Torres, chief operations and North America programs officer, IHI. “We have so much to learn when we center our approach around what matters most to the people we are serving. We hope other hospitals and communities are inspired to work together to implement the changes described in this paper and improve care nationwide with their patients, families, and ED care teams.”
The eight participating hospitals were Abbott Northwestern Hospital (Allina Health), Minneapolis, MN; Cohen Children’s Medical Center (Northwell Health), New Hyde Park, NY; Hoag Memorial Hospital Presbyterian (Providence St. Joseph Health), Newport Beach, CA; Kaiser Permanente South Sacramento Medical Center, Sacramento, CA; Maine Medical Center (MaineHealth), Portland, ME; Memorial Hermann Northeast Hospital, Houston, TX; Providence Regional Medical Center Everett, Everett, WA; and South Seminole Hospital (Orlando Health), Longwood, FL.
“This work is incredibly heartening, timely, and necessary—the nation must do better to support these patients,” said Tyler Norris MDiv, chief executive, WBT. “It is so inspiring to see how the learning community created a culture of caring that will continue to drive change and improvements system-wide—moving from triaging problems to cultivating well-being among patients and staff.”
The paper includes recommendations based on the experiences of the learning community teams, including, but not limited to:
“This was an initial step in ensuring we have the research and practical knowledge to ultimately build systems of care in every community—to prevent needless pain, suffering, and deaths from mental health conditions and substance use disorders,” said Dr. Arpan Waghray, chief medical officer, WBT.
Well Being Trust is a national foundation dedicated to advancing the mental, social, and spiritual health of the nation. Created to include participation from organizations across sectors and perspectives, Well Being Trust is committed to innovating and addressing the most critical mental health challenges facing America, and to transforming individual and community well-being. www.wellbeingtrust.org. Twitter: @WellBeingTrust
About the Institute for Healthcare Improvement—The Institute for Healthcare Improvement (IHI) is an independent not-for-profit organization based in Boston, Massachusetts, USA. For more than 25 years, IHI has used improvement science to advance and sustain better outcomes in health and health systems across the world. IHI brings awareness of safety and quality to millions, catalyzes learning and the systematic improvement of care, develops solutions to previously intractable challenges, and mobilizes health systems, communities, regions, and nations to reduce harm and deaths. IHI collaborates with a growing community to spark bold, inventive ways to improve the health of individuals and populations. IHI generates optimism, harvests fresh ideas, and supports anyone, anywhere who wants to profoundly change health and health care for the better. Learn more at ihi.org.