Reduced community resources can present huge challenges for people with behavioral health issues and for acute care settings, but the Carolinas Medical Center (CMC) in North Carolina is finding ways to adapt.
CMC needed to find cost-effective ways to protect and care for vulnerable people with behavioral health problems who present in the emergency department. A Journal of Nursing Administration article
discusses CMC's efforts to address these issues, and what works. Among the range of solutions implemented are environmental modifications and staff engagement.
Management began by teaming up to turn a vacant nursing unit into a 19-bed quiet holding area for patients exhibiting behavioral health problems in the ED. This area is designed to be more conducive to the needs of behavioral health patients as they await transition to inpatient services.
A clinical nurse specialist collaborated with leadership to design an education plan for staff. To better understand and meet the needs of patients with behavioral health conditions, the team visited an inpatient behavioral health facility and gathered information from acute care facilities with inpatient units. They reviewed policies, procedures, and best practices for providing care and safety for patients with behavioral health issues, and for managing escalating behavior. Among the initiatives implemented were a mandatory 2.5-day class for staff that incorporates the competencies identified through research, education on common psychiatric illnesses, and CPI training
The article's authors report that as a result of their ongoing efforts, they've been able to free up scarce resources in the ED and general nursing units while providing a safer environment for patients and staff. They've reduced Constant Observation (CO) sitter hours, sitter salary costs, violent incidents, and the use of restraint.
Learn more about CMC's evolving practices and interdepartmental collaboration in Managing Patients With Behavioral Health Problems in Acute Care: Balancing Safety and Financial Viability