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 Franklin County Mental Health Collaborative

Facing reduced bed capacity and higher demand for behavioral health services, central Ohio psychiatric providers are working together to ensure continued access for patients in need of inpatient services.

Franklin County’s three adult hospital systems (Mount Carmel Health, OhioHealth and the OSU Wexner Medical Center) are partnering with Netcare, the local crisis intervention facility, Twin Valley Behavioral HealthCare, a state psychiatric hospital, and Ohio Hospital for Psychiatry and Dublin Springs, two free-standing psychiatric facilities, to communicate daily on psychiatric bed availability. Their goal: place the right patient in the right bed at the right time.

Known informally as "the bedboard group," the providers convened in May of 2008 to discuss the possibility of managing mental health patient flow across the community, rather than facility by facility. The imputus of the initiatve was a signifiant back-up of patients waiting for a psychiatric bed in hospital emergency departments, hospital med-surg/ICU beds, and community crisis intervention facilities. The group understood that boarding of psychiatric patients, especially in the ED, places them in environments not conducive to the standard of care required for their mental health crisis.

After months of discussion, the group agreed on a community protocol, whereby patients waiting the longest for placement in a psychiatric bed are placed in the next available bed -- regardless of the facility in which the patient is waiting and regardless of the facility in which the bed becomes open. Daily conference calls (weekends and holidays included) are held to place patients into available psych beds, and communication takes place throughout the day when a new bed becomes open. To assist with this communication among providers, a Web-based database -- known as "the bedboard" -- was developed, it was funded by the Columbus Foundation and is managed by the COHC.

As a result of this collaborative effort, hospitals initially saw  significant reductions in the length of stay of mental health patients in the emergency department. Over the past two years, the volume of patients in Franklin County needing inpatient psychiatric care has skyrocketed.

Emergency Department, Med/Surg Volumes
May '09 to May '17

Due to the significant influx of psychiatric patients in hospital EDs, the bedboard group has implemented a "surge" protocol. According to protocol, Emergency Departments reaching an unsafe level of mental health patients can declare "surge status." While on surge, patients from that hospital's ED are placed into available psychiatric beds  before all others, until the ED returns to a more safe environment.
 

 



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