'Psych ED' relieves main department
A psychiatric ED can relieve the overcrowding pressure in the main ED, but it doesn't guarantee a solution to the boarding problem, says Steve Sterner, MD, chief clinical officer and an emergency physician at Hennepin County Medical Center in Minneapolis, and chair of a joint American College of Emergency Physicians (ACEP)/Minnesota Medical Association task force evaluating psychiatric bed availability and the boarding of psychiatric patients
"What the psych ED does for you is it gives you one more place to board patients," he notes. "You still have same the inpatient bed issues, or lack of [inpatient bed] issues, but you can get the patients out of your general ED into a facility that is designed around managing and boarding psychiatric patients."
Boarding, Sterner says, is a big problem for any large ED. "Less than half the medical hospitals have an acute inpatient 'psych' unit," he says. "If you do, you need to make sure those beds are [adequately] staffed and you have enough beds."
Just building a psychiatric ED to simply hold boarded psychiatric admissions "seems to be counterproductive compared to the ease of opening up more inpatient beds," says Sterner, who says Hennepin has done both. "We added 18 psychiatric inpatient beds last year as well as expanding our psych ED, which has doubled in size in the last couple of years," he says. The Hennepin psychiatric ED, which is immediately next to the EDs, has 18 beds, including a locked unit, says Sterner.
Sterner believes Hennepin has the only "psych ED" in the state, but he says some frustrated ED managers soon will be changing that status. "Some other local EDs are boarding anywhere from three to 20 patients on any given Monday, and they have become disrupting enough to operations that the managers have gone to administration," he says. "I know of two for certain [Regions Hospital in St. Paul and University of Minnesota Children's Hospital, Fairview] that have decided to create a psychiatric ED."
A psychiatric ED can relieve the overcrowding pressure in the main ED, but it doesn't guarantee a solution to the boarding problem, says Steve Sterner, MD, chief clinical officer and an emergency physician at Hennepin County Medical Center in Minneapolis, and chair of a joint American College of Emergency Physicians (ACEP)/Minnesota Medical Association task force evaluating psychiatric bed availability and the boarding of psychiatric patients.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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