August 2012 Update

As mentioned in the last IBHI Newsletter, the Joint Commission has issued two changes in accreditation requirements for hospitals which are designed to improve this aspect of care, and seem likely to generate interest on the part of hospitals. These changes have the potential to affect community based providers other than hospitals. The new requirements are Standard LD.04.03.11 and Standard PC.01.01.01. They are identified as Revisions to Address Patient Flow Through the Emergency Department. Are you, or do you know a hospital which is, concerned about meeting these new requirements? Would you be interested in helping to address the issues which are raised by these changes?

The new requirements expect hospitals and related accredited organizations to “Set Goals”for the components of the patient flow process, and identifies examples of the areas to be considered. The Commission has required some quality improvement initiatives for some time, but is becoming more specific about what that requires. The standard also specifically calls for hospitals to develop plans for limiting “boarding.”   This is a frequent topic in our Emergency Care Improvement Collaborative and Seminars. The second standard calls essentially for active treatment for people who remain in Emergency care while awaiting a placement. These are people often thought of as “boarded.”

These and other modifications included in the new standards seem likely to require many hospitals to make some serous changes in the Emergency Department operations. They will need to:

  • Organize quality improvement processes for behavioral health services in Emergency departments and elsewhere in their hospitals. These efforts will need to address specific measures of service such as length of stay and frequency and duration of use of restraint or seclusion.
  • Develop behavioral health treatment for people in Emergency Departments for more than a brief time who require these services.
  • Develop improved connections with other community providers which will reduce the likelihood of having to “board” people.

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

IBHI will be offering a Seminar on Improving Emergency Department Care for People with Behavioral Health Problems 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. More information on this will be forwarded soon and can be found on the IBHI website.

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