2.50
Hdl Handle:
http://hdl.handle.net/10755/162532
Type:
Presentation
Title:
Tele-Mental Health: A Successful Model for Behavioral Health Integration
Abstract:
Tele-Mental Health: A Successful Model for Behavioral Health Integration
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Laws, Stephanie, RN, BSN
P.I. Institution Name:Union Hospital Health Group's Richard G. Lugar Center for Rural Health
Title:Project Association
Contact Address:1433 N. 6½ Street, Terre Haute, IN, 47807, USA
Contact Telephone:812-238-7479
Co-Authors:Erik Southard, RN, MS, CFNP
[Annual Conference] Clinical Topic: (Geographic Location: Midwest)
For people living in rural areas, the distance to specialty care providers often places restrictions on access to essential services, including behavioral health care. Telemedicine provides one possible answer to facilitate the delivery of quality and specialty health care services to rural areas via live-videoconferencing. The purpose of this project was to objectively quantify the impact of providing "real-time" mental health evaluations in a critical access hospital (CAH) emergency department (ED) before and after the implementation of a live-videoconference connection between a community mental health center and a CAH ED.

Implementation: Prior to implementation of this project mental health assessments were limited to only ?normal? business hours Monday thru Friday excluding weekends and holidays. Due to the remote location of the CAH ED, behavioral health assessments were often not completed due to travel time and the pre-existing shortage of behavioral health care providers in the area. Specific policies and procedures were developed in collaboration with the community mental health center and CAH administration to facilitate "real-time" behavioral health consults with expanded coverage times, 7 days a week utilizing telemedicine technology. An extensive procedural and technical education program was deployed to the medical staff as well as the ED staff related to the project. The first year of the project was evaluated for impact on access, processes, outcomes, and costs. The shift distribution of emergency consultations in the ED was compared with baseline need data. Measures of treatment duration and time spent in the ED were analyzed. Symptom severity, well-being, functioning, and risk of harm were tracked at each treatment session using the CORE-OM, a standardized self-report symptom severity instrument. Program costs were estimated before and after implementation.

Outcomes: Forty-two urgent consults were completed at the CAH ED. ED consult times mirrored the pre-implementation distribution of ED need, suggesting that the goal of offering "around the clock" mental health access was met. Average ED length of stay was under 3 hours, and only 3 of 24 consult patients (12.5%) stayed in the ED longer than 4 hours within the first six months. Cost estimates suggested a significant reduction in cost per treatment episode along with increased access.

Recommendations: Mental health-related visits constitute a significant and increasing burden of care in U.S. emergency departments with emergency nurses often being confronted with unanticipated situations requiring immediate intervention while combating the allocation of limited resources. Telemedicine is one methodology that has been proven to enhance the scope and quality of the services provided by rural health care facilities across the nation. Policy makers must continue their efforts at placing mental health at the forefront of their agendas to ensure that funding is secured for the development of innovative programs aimed at addressing these issues. While CAH EDs play an important role in providing mental health services, most lack appropriate treatment and referral processes, therefore, further research is needed to identify best-practice guidelines for the provision of mental health care in emergency care environments.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleTele-Mental Health: A Successful Model for Behavioral Health Integrationen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162532-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Tele-Mental Health: A Successful Model for Behavioral Health Integration</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Laws, Stephanie, RN, BSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Union Hospital Health Group's Richard G. Lugar Center for Rural Health</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Project Association</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1433 N. 6&Atilde;&sbquo;&Acirc;&frac12; Street, Terre Haute, IN, 47807, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">812-238-7479</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">slaws@uhhg.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Erik Southard, RN, MS, CFNP</td></tr><tr><td colspan="2" class="item-abstract">[Annual Conference] Clinical Topic: (Geographic Location: Midwest)<br/>For people living in rural areas, the distance to specialty care providers often places restrictions on access to essential services, including behavioral health care. Telemedicine provides one possible answer to facilitate the delivery of quality and specialty health care services to rural areas via live-videoconferencing. The purpose of this project was to objectively quantify the impact of providing &quot;real-time&quot; mental health evaluations in a critical access hospital (CAH) emergency department (ED) before and after the implementation of a live-videoconference connection between a community mental health center and a CAH ED. <br/><br/>Implementation: Prior to implementation of this project mental health assessments were limited to only ?normal? business hours Monday thru Friday excluding weekends and holidays. Due to the remote location of the CAH ED, behavioral health assessments were often not completed due to travel time and the pre-existing shortage of behavioral health care providers in the area. Specific policies and procedures were developed in collaboration with the community mental health center and CAH administration to facilitate &quot;real-time&quot; behavioral health consults with expanded coverage times, 7 days a week utilizing telemedicine technology. An extensive procedural and technical education program was deployed to the medical staff as well as the ED staff related to the project. The first year of the project was evaluated for impact on access, processes, outcomes, and costs. The shift distribution of emergency consultations in the ED was compared with baseline need data. Measures of treatment duration and time spent in the ED were analyzed. Symptom severity, well-being, functioning, and risk of harm were tracked at each treatment session using the CORE-OM, a standardized self-report symptom severity instrument. Program costs were estimated before and after implementation. <br/><br/>Outcomes: Forty-two urgent consults were completed at the CAH ED. ED consult times mirrored the pre-implementation distribution of ED need, suggesting that the goal of offering &quot;around the clock&quot; mental health access was met. Average ED length of stay was under 3 hours, and only 3 of 24 consult patients (12.5%) stayed in the ED longer than 4 hours within the first six months. Cost estimates suggested a significant reduction in cost per treatment episode along with increased access. <br/><br/>Recommendations: Mental health-related visits constitute a significant and increasing burden of care in U.S. emergency departments with emergency nurses often being confronted with unanticipated situations requiring immediate intervention while combating the allocation of limited resources. Telemedicine is one methodology that has been proven to enhance the scope and quality of the services provided by rural health care facilities across the nation. Policy makers must continue their efforts at placing mental health at the forefront of their agendas to ensure that funding is secured for the development of innovative programs aimed at addressing these issues. While CAH EDs play an important role in providing mental health services, most lack appropriate treatment and referral processes, therefore, further research is needed to identify best-practice guidelines for the provision of mental health care in emergency care environments.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:29:47Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:47Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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