title: Improving Quality of Emergency Care Through Integration of Mental Health.
abstract: The goal of this study was to better integrate emergency medical and psychiatric care at a large urban public hospital, identify impact on quality improvement metrics, and reduce healthcare cost. A psychiatric fast track service was implemented as a quality improvement initiative. Data on disposition from the emergency department from January 2011 to May 2012 for patients impacted by the pilot were analyzed. 4329 patients from January 2011 to August 2011 (pre-intervention) were compared with 4867 patients from September 2011 to May 2012 (intervention). There was a trend of decline on overall quality metrics of time to triage and time from disposition to discharge. The trend analysis of the psychiatric length of stay and use of restraints showed significant reductions. Integrated emergency care models are evidence-based approach to ensuring that patients with mental health needs receive proper and efficient treatment. Results suggest that this may also improve overall emergency department's throughput.
authors.affiliation: Yale University School of Nursing, New Haven, CT, USA.|Division of Behavioral Health in Satcher Health Leadership Institute, Morehouse School of Medicine, Atlanta, GA, USA.
authors.forename: Martha
authors.initials: M
authors.lastname: Okafor
authors.affiliation: Division of Behavioral Health in Satcher Health Leadership Institute, Department of Psychiatry and Behavioral Sciences, Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA, 30310, USA.
authors.forename: Glenda
authors.initials: G
authors.lastname: Wrenn
authors.affiliation: Division of Behavioral Health in Satcher Health Leadership Institute, Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA, 30310, USA. vede@msm.edu.
authors.forename: Victor
authors.initials: V
authors.lastname: Ede
authors.affiliation: Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA, 30310, USA.
authors.forename: Nana
authors.initials: N
authors.lastname: Wilson
authors.affiliation: Center for Health Services Research, Institute of Health Administration, Georgia State University, Atlanta, GA, USA.
authors.forename: William
authors.initials: W
authors.lastname: Custer
authors.affiliation: Georgia State Department of Behavioral Health and Developmental Disabilities, Atlanta, GA, 30303, USA.
authors.forename: Emile
authors.initials: E
authors.lastname: Risby
authors.affiliation: Department of Behavioral Health, Grady Health System, Atlanta, GA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Claeys
authors.affiliation: Georgia State Department of Behavioral Health and Developmental Disabilities, Atlanta, GA, 30303, USA.|Good Neighbor Community Services, Richmond, VA, USA.
authors.forename: Frank E
authors.initials: FE
authors.lastname: Shelp
authors.affiliation: Grady Health System, Atlanta, GA, USA.|Department of Emergency Medicine, Emory University, 531 Asbury Circle, Annex Building, Suite N340, Atlanta, GA, 30322, USA.
authors.forename: Hany
authors.initials: H
authors.lastname: Atallah
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA, 30310, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Mattox
authors.affiliation: Satcher Health Leadership Institute, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA, 30310, USA.
authors.forename: David
authors.initials: D
authors.lastname: Satcher
mesh_terms: D003362:Cost-Benefit Analysis; D004637:Emergency Services, Psychiatric / Q000191:economics / Q000458:organization & administration / Q000592:standards*; D005845:Georgia; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D058996:Quality Improvement / Q000191:economics / Q000458:organization & administration*; D019984:Quality Indicators, Health Care / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D014218:Triage / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends
keywords: Behavioral health; Emergency care; Integrated care; Psychiatric fast track service