The CAPES Unit: Development of a Comprehensive Regional Center for Quality Emergency Medical/Psychiatric Treatment

14.00
Hdl Handle:
http://hdl.handle.net/10755/162996
Type:
Presentation
Title:
The CAPES Unit: Development of a Comprehensive Regional Center for Quality Emergency Medical/Psychiatric Treatment
Abstract:
The CAPES Unit: Development of a Comprehensive Regional Center for Quality Emergency Medical/Psychiatric Treatment
Conference Sponsor:Emergency Nurses Association
Conference Year:2005
Author:Morse, Ruth, RN, MSN, CEN, CAN, BC
P.I. Institution Name:Wilmington Hospital/Christiana Care Health System
Title:Manager, Emergency Services
Contact Address:501 West 14th Street, Wilmington, DE, 19801, USA
Contact Telephone:(302) 428-4888
Co-Authors:Paula Fasano-Piectrazak, RN, BSN, CEN; Regina Janney, RN, C, MS; M. Susan MacCord, RN, ADN, CEN; Susan Palmer, RN, BSN, CEN
Clinical Topic: The Crisis and Psychiatric Emergency Services (CAPES), a partnership between Christiana Care Health System (CCHS) and the State of Delaware Division of Substance Abuse and Mental Health (DeDSAMH), joined forces to create a comprehensive regional center for patients with mental-health emergencies. The CAPES unit is the entry point for evaluation, observation, and disposition to treatment. The goal is to provide comprehensive medical and psychiatric evaluation in a timely manner, 24 hours a day, 7 days a week; more specifically, CAPES will enable disposition within 8 hours. Ideally, this will bring stability to an overburdened system and, possibly, become a care model for other similarly challenged systems. Implementation: Representatives from the DeDSAMH, CCHS emergency departments, and the CCHS Department of Psychiatry met numerous times to discuss how best to merge services to provide clinical excellence for the psychiatric patient requiring medical emergency intervention. This group completed the search for a secure, private area in close proximity to medical emergency services. The Wilmington Hospital Emergency Department staff was receptive to providing the necessary area by relocating its administrative offices. The State of Delaware provided funds for staffing the unit with mental-health associates, crisis intervention staff, and third-year psychiatric residents. CCHS provided psychiatric crisis nurses (i.e., RNs with a minimum of five year's psychiatric experience), a full-time psychiatrist, construction funding, and supplies. Triage screening tools were developed to determine which patients needed medical evaluation first and which patients needed immediate psychiatric services. Outcomes: Preliminary data indicate a decrease in length of stay for the Wilmington Hospital CAPES patient, as compared to the average length of stay for those in need of psychiatric and medical emergency services prior to initiation of the program. In addition, the number of patients referred to outpatient community resources significantly increased from the number of referrals before implementation of the CAPES program. Recommendations: According to preliminary results, a comprehensive, regional program such as CAPES may benefit patients with mental-health emergencies and the overburdened health care systems that serve them. Further research is needed to fully evaluate the effectiveness of the CAPES program. Recommendations for future research include the following: 1) Determine the effects of the CAPES unit on recidivism of the psychiatric patient; 2) Determine the effectiveness of the triage screening tools for appropriate patient placement; 3) Evaluate the viability of the collaborative relationship between the DeDSAMH and CCHS; and 4) Determine if an inverse relationship exists between voluntary and involuntary admissions.
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.titleThe CAPES Unit: Development of a Comprehensive Regional Center for Quality Emergency Medical/Psychiatric Treatmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162996-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The CAPES Unit: Development of a Comprehensive Regional Center for Quality Emergency Medical/Psychiatric Treatment</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">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Morse, Ruth, RN, MSN, CEN, CAN, BC</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Wilmington Hospital/Christiana Care Health System</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Manager, Emergency Services</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">501 West 14th Street, Wilmington, DE, 19801, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(302) 428-4888</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">rmorse@christianacare.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Paula Fasano-Piectrazak, RN, BSN, CEN; Regina Janney, RN, C, MS; M. Susan MacCord, RN, ADN, CEN; Susan Palmer, RN, BSN, CEN<br/></td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: The Crisis and Psychiatric Emergency Services (CAPES), a partnership between Christiana Care Health System (CCHS) and the State of Delaware Division of Substance Abuse and Mental Health (DeDSAMH), joined forces to create a comprehensive regional center for patients with mental-health emergencies. The CAPES unit is the entry point for evaluation, observation, and disposition to treatment. The goal is to provide comprehensive medical and psychiatric evaluation in a timely manner, 24 hours a day, 7 days a week; more specifically, CAPES will enable disposition within 8 hours. Ideally, this will bring stability to an overburdened system and, possibly, become a care model for other similarly challenged systems. Implementation: Representatives from the DeDSAMH, CCHS emergency departments, and the CCHS Department of Psychiatry met numerous times to discuss how best to merge services to provide clinical excellence for the psychiatric patient requiring medical emergency intervention. This group completed the search for a secure, private area in close proximity to medical emergency services. The Wilmington Hospital Emergency Department staff was receptive to providing the necessary area by relocating its administrative offices. The State of Delaware provided funds for staffing the unit with mental-health associates, crisis intervention staff, and third-year psychiatric residents. CCHS provided psychiatric crisis nurses (i.e., RNs with a minimum of five year's psychiatric experience), a full-time psychiatrist, construction funding, and supplies. Triage screening tools were developed to determine which patients needed medical evaluation first and which patients needed immediate psychiatric services. Outcomes: Preliminary data indicate a decrease in length of stay for the Wilmington Hospital CAPES patient, as compared to the average length of stay for those in need of psychiatric and medical emergency services prior to initiation of the program. In addition, the number of patients referred to outpatient community resources significantly increased from the number of referrals before implementation of the CAPES program. Recommendations: According to preliminary results, a comprehensive, regional program such as CAPES may benefit patients with mental-health emergencies and the overburdened health care systems that serve them. Further research is needed to fully evaluate the effectiveness of the CAPES program. Recommendations for future research include the following: 1) Determine the effects of the CAPES unit on recidivism of the psychiatric patient; 2) Determine the effectiveness of the triage screening tools for appropriate patient placement; 3) Evaluate the viability of the collaborative relationship between the DeDSAMH and CCHS; and 4) Determine if an inverse relationship exists between voluntary and involuntary admissions.</td></tr></table>en_GB
dc.date.available2011-10-27T10:37:45Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:37:45Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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