PERSPECTIVE

Closing the Gap on Psychiatric Care in the Emergency Department

Published August 02, 2019

graphic showing domains of behavioral healthcare in the emergency room

Vituity, a physician-led and -owned organization, has been working on the front lines of acute care delivery for nearly 50 years and understands the unique challenges of the emergency department (ED).

Empowering EDs to Serve All Emergencies

Emergency Psychiatric Intervention (EPI) is an approach designed by Vituity physicians on the front lines of emergency medicine and acute psychiatry. EPI ensures that EDs are empowered to properly and more efficiently evaluate and treat behavioral health patients from the moment they enter the ED through discharge.

Emergency Psychiatric Intervention at AMITA Health

AMITA Health is an award-winning health system delivering care to nearly 6.6 million residents in and around Chicago. Beginning in mid-2018, four AMITA hospital locations participated in the launch of EPI. All sites experienced high volumes of behavioral health patients in their EDs and were looking for a risk stratification method and new medication protocols that lead to more efficient and accurate diagnoses and treatment, and faster discharge rates.

The participating locations achieved remarkable results within six months after implementing EPI. Care teams across levels changed their processes and as a result, dramatically improved the quality of care they provide (prescribing patterns) and significantly improved their throughput times.

  • Reduced length of stay through risk stratification and split flow processing
  • Improved quality/experience through early and appropriate medication management
  • Improved resource utilization through faster admissions and discharge process

Learn more about EPI at AMITA Health in this Chicago Tribune article.



How Emergency Psychiatric Intervention Works

At its core, the EPI approach includes expertise and proven results in three areas:

  • Elimination of over-processing
  • Risk stratification and split flow processing
  • Early and appropriate medication management

These three principles are already embedded in the standard processes that serve patients with medical complaints in the ED. However, they have not been successfully applied to the behavioral health population.

Through the elimination of unnecessary roadblocks to expedite treatment, patients receive earlier assessments and differentiated care based on diagnosed need. Also, EPI creates core efficiencies to assess, evaluate, and treat behavioral health patients, reducing redundancies and freeing up time to care for more patients. All of this is achieved through a comprehensive education program and toolkit on behavioral healthcare best practices that minimize patient holding and improve care quality and patient experience.

Transforming the ED for All Stakeholders

The impact of effectively and compassionately serving all ED patients, including those with behavioral health conditions, is profound.

  • Hospitals and health systems improve clinical quality, profitability, and patient scores while elevating their brand.
  • EDs achieve higher throughput and better care for all, with fewer behavioral patient admissions and more stable, engaged staff.
  • Providers gain new confidence in their ability to heal, rekindling the joy of practicing medicine.
  • All patients know on a very human level that they're properly cared for with dignity and respect.

Implementing EPI requires formalized training for emergency providers as well as access to dedicated behavioral health services. To learn more, contact [email protected].

Partnering to improve patient lives

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