Becker's Hospital Review

47 FINANCE CMO / CARE DELIVERY Viewpoint: What hospitals can do to help EDs overwhelmed by psychiatric patients By Megan Knowles A s hundreds of patients facing psychiatric emergencies are ad- mitted to emergency departments each year, hospitals can help prevent EDs from being overwhelmed by taking several key actions, starting with better collaboration, an emergency medicine di- rector wrote in a STAT op-ed. "Millions of Americans with mental health issues are not getting the care they need. It's a crisis so profound that it is overwhelming emer- gency departments and the entire healthcare system," wrote op-ed author Anne Zink, MD, medical director for emergency medicine at Palmer, Alaska-based Mat-Su Regional Medical Center. e causes behind this trend include too few outpatient resources and inpatient treatment options for mental health issues, separate systems for treating mental health and physical health, and a mental health specialist shortage, Dr. Zink said. Here are five insights from the op-ed: 1. "Given the consequences of inaction and insufficient resources, healthcare organizations need better tools, solutions and integrated care approaches so patients leave hospitals not just physically alive, but mentally thriving," Dr. Zink wrote. Healthcare providers can help patients thrive by treating mental health conditions like any other disease process, as opposed to treating them like acute flareups that easily can be forgotten or overlooked, Dr. Zink said. 2. Hospitals need an easier way to transfer patients to a higher level of care for psychiatric issues when they arrive at the ED, Dr. Zink said. "Better coordination with mental health providers, even bringing such providers into the initial decision-making process, would speed treat- ment and free up emergency department resources," she wrote. 3. Novel technology also can improve collaboration between emergen- cy and behavioral health providers to ensure all clinicians are on the same page. Mat-Su Regional Medical Center, along with most Alaska hospitals, are part of the collective medical network, which connects the facilities to other providers in the state and across the U.S., Dr. Zink said Since patient information is aggregated, when a patient arrives at the ED, the network gives real-time alerts on a patient's data to the physi- cians, including their history of psychiatric care and ED use patterns. "For my hospital, this tool has been a game changer," Dr. Zink wrote. 4. Additionally, expanding access to behavioral telehealth can help more patients get the mental healthcare they need before they resort to the ED, Dr. Zink said. "rough a virtual care platform, patients with transportation issues and other challenges can receive counseling at home more easily than if they were to wait hours for a psychiatric worker to conduct an initial consultation in person," she wrote. 5. Hospitals must consider new ways to give healthcare workers re- al-time insights into psychiatric patients' needs, better ways to triage psychiatric patients to more appropriate caregivers, and be open to sharing data and best practices with other hospitals to improve pa- tients' quality of life, Dr. Zink said. "e better able we are to treat patients with mental and behavioral is- sues, communicate and collaborate effectively, and match patients with the appropriate resources outside of the emergency department, the better off our health system and our patients will be," Dr. Zink wrote. n Duke University Hospital rolls out AI system for sepsis By Harrison Cook D urham, N.C.-based Duke University Hospital in No- vember launched Sepsis Watch, a system that uses artificial intelligence to help identify patients in the early stages of sepsis, according to IEEE Spectrum. Duke University Hospital will deploy the system in its emer- gency department before extending it to the general hos- pital floor and intensive care unit. "The most important thing is to catch cases early, before they get to the ICU," Suresh Balu, project lead and director of the Duke Institute for Health Innovation, told IEEE Spectrum. The Sepsis Watch system can identify cases based on nu- merous variables, including vital signs, lab test results and medical histories. The AI was trained from 50,000 patient records and more than 32 million data points. While oper- ating, the system pulls information from medical records every five minutes to evaluate patients' conditions, offering real-time analytics physicians can't provide. When the AI system detects a patient who may be in the early stages of sepsis, it alerts a nurse on the hospital's rap- id-response team who will either dismiss the alert, place the patient on a watch list or contact a physician about starting treatment. The system will also walk staff through a sepsis treatment checklist using protocols outlined by the Surviving Sepsis Campaign. "The model detects sepsis," Mark Sendak, MD, physician and data scientist, told IEEE Spectrum. "But most of the ap- plication is focused on completing treatment." n

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