Transcript Rapid Access to Psychiatric Care

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
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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:
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
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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!
Mental Health Urgent Care Clinic

Patients are seen, on average, within 7days of their ED visit or inpatient
discharge and provided up to 3 sessions
to bridge them to appropriate services.
419
400
3-mos Pre Post
ED Visits
300
200
 Outcome:
 During their involvement with the
UCC, out of 346 patients served in
year 1, only 3% attended the ED and
4% were admitted.
100
0
PRE
POST
2-YEAR ED COMPARATOR

There was a 69% decrease in ED visits
when examining the 346 patients 3months pre and post UCC
involvement.
15.0%
Mental
Health…
0000
Number of Particip
12.8%
11.6%
1974
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From 2008-09 to 2009-10 the program10.0%
saw a decrease in early repeat ED
visits for Mental Health by 1.2% and 5.0%
for Addictions by 1.9%.
9.0%
1831
7.1%
364
240
0.0%
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2008/2009
2009/2010
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.
Strongly Agree

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Positive patient satisfaction
results as they are now
services by one team
for Concurrent Disorders.
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Agree
Undecided
Disagree
Strongly
Disagree
Outcome:
Decrease in ED Visits &Inpatient Admissions
140
120
100
80
60
40
20
0
ED Visits
Pre
Post
% Decrease
64%
15%
25
20
17
9
3
(31 Participants)
6
(24 Participants)
33%
18
12
9
(17 Participants)
37%
8
5
12
(7 Participants)
Months in Program
51%
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51%
51%
92%
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.
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Outcome:
•Positive patient
satisfaction results
from the 346
patients who have
attend groups.
Patient Satisfaction Survey
30
Topic was relevant to patient needs
25
Information discussed was understandable
20
19
18
19
Enough time to discuss
17
Facilitator was knowledgable
15
15
13
10
10
11
9
8
5
8
1
2
1
1
0
•A random sample
of 21 participants shows
a decrease of ED visits
by 62% and a decrease
of admissions by 86%,
3-month post discharge.
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3 Month post discharge
for ED Visits /
Inpatients Readmits
25
20
15
10
5
0
# Patients Visited
ER
3-mos post
discharge
# Patients Admitted
IPS 3-mos post
discharge
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 contact
Vivian Demian, Program Director for Mental Health
Oakville Trafalgar Memorial Hospital
(905) 845-2571 ext 5640 - [email protected]
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