Complex Care for Behavioral Health Comorbidities Seen to Lower LOS

Jennifer Thew, RN, October 3, 2017

Care Criteria

The organization realized there was a need for the unit when its consult liaison team saw a 38% increase in consultations for this patient population in the main hospital setting.

"These were patients that we were seeing in our hospital," she says. "Previously the [consult liaison team members] were going all over the hospital making sure they didn't miss anybody. Now, we're able to cohort that team a little bit better."

The unit is staffed by registered nurses and patient care assistants who receive training in non-violent crisis intervention and education on being proactive with behavioral aspects of care and psychiatric illnesses as well as traditional medical/surgical knowledge, Blankenhorn says.

To be admitted to the unit, patients must have a primary med/surg diagnosis and a coexisting behavioral health diagnosis. However, they do not have to be in a mental health crisis to receive care.

"If somebody comes in and they're non-compliant with their diabetes [care plan] and their sugars are in the 500s, but they happen to have a long-term mental health diagnosis, that would be somebody that would be ideal because we can manage their medical issue while also making sure they don't backslide with their psychiatric medications or the treatment they were receiving psychiatrically," she explains.

In addition to a variety of medical diagnoses, patients may also present with behavioral health issues such as delirium, toxic ingestion, overdose, or substance withdrawal.

An active mental health crisis is not necessary for admission, however. Additionally, patients from the hospital's inpatient mental health unit who require medical intervention may also be cared for on the unit.

"We're also looking at our relationship with other facilities that send us patients with mental health diagnoses that have a medical problem so we can develop relationships and really enhance that care for the patient," Blankenhorn says.

Promising Outcomes

In addition to providing consistent, patient-centered care, Blankenhorn says the unit's goals are to decrease the need for one-to-one care and length of stay.

"Oftentimes, this patient population could have a longer length of stay if they get mixed in with the crowd," she says.

Jennifer Thew, RN

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders Media.

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