The Challenge: Behavioral Health Boarding and ED Throughput

Allen Hospital was facing an increasingly difficult challenge caring for behavioral health patients. The hospital had a 21-bed inpatient behavioral health unit and one full-time psychiatrist. In the surrounding community there was often a 3-month wait for an outpatient psychiatric visit—thus many patients turned to the hospital for care. The demand for behavioral health evaluations was continually overloading the hospital’s resources.

In the emergency department (ED), where the problem was at its most acute, patients who required behavioral health evaluations faced extended wait times. Like many community hospitals throughout the country which face similar challenges, these patients were often boarded in hallways, or scattered in rooms throughout the ED while they awaited evaluations.

Increased wait times meant patient dispositions were not being met in a timely manner. The lack of resources and specialized psychiatric expertise led to longer boarding times thus increasing patient agitation. The hospital’s resources were also stretched thin on the inpatient side. Allen had one locum psychiatrist and additional locums were repeatedly burning out. The psychiatrists often could not get around the hospital for all the consults necessary within 24 hours. Hospital leadership knew that Allen had to make a change.

The Solution: Implementing a Virtual Behavioral Health Program to Support ED Operations

Allen’s solution was three-pronged:

• A new investment in on-site behavioral health consultants and psychiatric safety techs.

• A physical reorganization of the ED.

• A partnership with Access TeleCare to provide both emergency and inpatient virtual behavioral health consults.

The hospital partnered with Access TeleCare to implement a 100 percent virtual behavioral health care program. The program provides 24/7 psychiatric coverage by a team of psychiatrists and psychiatric mental health nurse practitioners (PMHNPs), led by a Psychiatrist Regional Medical Director. The virtual team provides all diagnosis, treatment, and medication management services and is an integral part of the on-site team’s processes from admission to discharge, including daily rounding and 24/7/365 on-call coverage.

“Our successful partnership with Access TeleCare at Allen Hospital showed that we could help alleviate the stress placed on our other facilities. Access TeleCare is a helpful morale booster to our doctors and nurses while also providing best-in-class care for our patients.”

Calvin Heller Director, Telehealth UnityPoint Health