Psychiatric Inpatient and Emergency Department Challenges

Inpatient Challenges

• A Resource on Managing Patient Aggression
  Mental health professionals and others who often have to evaluate and manage the risk of violence by patients may benefit from a simple tool to more accurately make a risk assessment. A study showed that when researchers used the "Historical, Clinical, Risk Management 20 -Clinical" (HRC-20-C) scale - a brief, structured risk assessment tool -  their potential to accurately anticipate violence by residents increased to a level nearly as high as the faculty psychiatrists', who had an average of 15 years more experience.
• Check out the cover story in AHA's October issue of Trustee.  It focuses on ED interventions to curb overuse through case management and community support.  Learn what your colleagues are doing!
  
• TrendWatch: Redundant, Inconsistent and Excessive: Administrative Demands Overburden Hospitals (August 2008)
• AHA Behavioral Health Task Force Report: AHA Behavioral Behavioral Health Challenges in the General Hospital: Practical Help for Hospital Leaders  (09/17/07)
• Care of Adults With Mental Health and Substance Abuse Disorders in U.S. Community Hospitals, 2004 - HCUP Fact Book No. 10. AHRQ Publication No. 07-0008  (January 2007)
• Report from the President’s New Freedom Commission on Mental Health
• President’s New Freedom Commission on Mental Health Subcommittee on Acute Care: Background Paper  (June 2004)
• President’s New Freedom Commission on Mental Health: Executive Summary and Roster  (July 2003)
• "Mental Health: A Report of the Surgeon General"  (1999)

Emergency Department Challenges

• AHA Governing Council Meeting of May 13, 2008:
  • Emergency Psychiatric Assessment, Carroll Cradock, Ph.D., Director Behavioral Health Services Advocate
    Illinois Masonic Medical Center
  • Psychiatric Nursing Medical Clearance Checklist
    Advocate Illinois Masonic Medical Center
  • IHA Collaboration Behavioral Health Steering Committee - Treatment of Psychiatric Patients in Emergency Departments, Deborah Taber RN MS, Administrative Director, Department of Psychiatry and Behavioral Sciences
    Evanston Northwestern Healthcare
• Illinois Hospital Association's Behavioral Health Steering Committee Best Practices Task Force's Final Report: Best Practices for the Treatment of Patients with Mental and Substance Use Illnesses in the Emergency Department  (Updated October 2007)
• CDC Report: Increase in Emergency Department Visits as Number of EDs declines; Mental Disorders are 3.5% of all ED Visits  - Advance Data from Vital and Health Statistics, Number 386, National Hospital Ambulatory Medical Care Survey: 2005 Emergency Department Summary (06/29/07)
• AHA case examples: Ensuring Effective Triage of Psychiatric Patients in the Emergency Department  
  • Behavioral Health Services and Geriatric Clinics, Munson Healthcare, Traverse City, MI 
  • Maine Medical Center and Spring Harbor Hospital, Greater Portland, ME 
  • McHenry County Crisis Services, Centegra Memorial Medical Center, Woodstock, IL 
  • Middlesex Emergency Crisis Area, Middlesex Hospital, Middletown, CT 
  • University of New Mexico Hospitals, Albuquerque, NM   
• Urgent Matters, a national program of the Robert Wood Johnson Foundation