September 2012 Update

IBHI offered a free webinar on October 10 at 2:00 Eastern Daylight Time, 1:00 PM Central, 12:00 Noon Mountain and 11:00 AM Pacific Time on Improving Emergency Department Flow and Meeting New JCAHO Standards.  This webinar was also an introduction to an IBHI full day seminar on Improving Emergency Department Care for People with Behavioral Health Problems to be held on Dec 5th in Las Vegas. The webinar was free.

Click here for a copy of the PowerPoint slides.


The Joint Commission has issued two changes in accreditation requirements for hospitals which are designed to improve emergency care and address “boarding.” These changes also have the potential to affect community based providers other than hospitals. The new requirements are revisions to Standard LD.04.03.11 and Standard PC.01.01.01; and are identified as Revisions to Address Patient Flow Through the Emergency Department.

If you, or a hospital or community provider you know, are interested in learningmore about meeting these new requirements, or would be interested in helping to address behavioral healthissues which are raised by these regulatorychanges this webinar is for you.  


The new Commission requirements expect hospitals and related accredited organizations to “Set Goals” for the components of the patient flow process, and it identifies examples of the areas to be considered. The standards are especially designed to encourage hospitals to develop plans for limiting “boarding.”   This has been a frequent topic in our Emergency Care Improvement Collaborative and Seminars. The second standard reinforces the need for focusing on people who remain in Emergency care while awaiting a placement within the context of the care available. These are people often thought of as “boarded.” 
 
Specifically, revisions to Standard LD.04.03.11 address the following concerns for all patients, including those with behavioral health emergencies:

  • Leadership use of data and measures to identify, mitigate, and manage issues affecting patient flow throughout the hospital
  • The management of ED throughput as a system-wide issue
  • Safety for boarded patients (the practice of holding patients in the ED or another temporary location after the decision to admit or transfer has been made)
  • Leadership collaboration with behavioral health providers and authorities

 For patients who have been boarded because of behavioral health emergencies, revisions to Standard PC.01.01.01 address safety in the following areas:

  • Environment of care
  • Staffing
  • Assessment, reassessment, and the care provided

These changes seem destined to require modification of  ED operations, and open a new era of connection between hospitals and community providers, which will demand greater understanding, coordination and joint quality improvement.

The IBHI Webinar addressed:
          -The importance of understanding the Commission’s expectations;
          -The value of having an organizational culture conducive to change
          -Some methods for improving flow in the Emergency Department
          -Brief examples of ways to address the connection with  community organizations to address the issue of “boarding.”

IBHI will be offering a full day seminar on Improving Emergency Department Care for People with Behavioral Health Problems and the new Joint Commission standards on Dec 5 in Las Vegas. This program will immediately precede the National Update on Behavioral Emergencies at the same location the succeeding two days. Click here for more information on this seminar.