INTEGRIS Health

PROJECT PURPOSE

Across the United States the emergency department remains the primary point of entry for those experiencing mental health crises. However, most emergency departments are ill equipped to handle such a specialized crisis. Patients experiencing mental health crises are often isolated in sterile and cold environments and their symptoms are exacerbated by the presence of disruptive noises. These individuals typically experience an extended stays (54% longer across the INTEGRIS Health system) due to difficulty finding psychiatric beds. Patients should be met with a therapeutic environment and a multidisciplinary team of professionals that are trained to treat individuals in such a vulnerable state. An ?Emergency Psychiatric Assessment, Treatment and Healing? unit or ?EmPATH? unit would allow for psychiatric assessment and evaluation to take place in a physical environment that is designed to be therapeutic, supportive, and minimally restrictive. This project, in partnership with Variety Care, would allow for development of an EmPATH unit at INTEGRIS Health?s largest facilities (INTEGRIS Health Baptist Northwest and INTEGRIS Health Southwest Medical Center) which host 56% of the system?s mental health . This project would also provide technology to connect the lower volume facilities with the same high quality clinical services in a virtual capacity.

EVIDENCE

EmPATH units boast significant improvements in patient outcomes, patient safety, and patient satisfaction. These units have proven effective diversion from unnecessary inpatient psychiatric hospitalizations and allow patients to receive clinically appropriate treatment at a lower level of care and lower cost. EmPATH units by design lead with empathic interactions and decrease coercive interaction. This seemingly simple shift in culture and environment has proven to decrease the average restraint rate from 14% to 1%. Systems that have successfully incorporated the EmPATH unit into mental health crisis care have observed a 75% decrease in psychiatric hospitalizations which allows for more clinically appropriate utilization of high demand acute psychiatric beds.

POPULATION DESCRIPTION

In FY21, INTEGRIS Health saw 6,337 Oklahomans that were experiencing a mental health crisis in the emergency department setting. COVID-19 has acted as a catalyst for the exacerbation of existing mental health concerns or creation of new mental health concerns for citizens across the state, especially young adults and adolescents. The consequences of heightened fears, loneliness, economic instability, and grief suggest that the psychological footprint of COVID-19 will far outlast the physical. Emerging bodies of evidence have begun to support the impact of COVID-19 on behavioral health concerns including increased anxiety, depression, and alcohol misuse. Those that have been identified to be of particular risk are of female sex, maintain a lower level of education, and maintain comorbid physical health conditions. Recent research suggests that behavioral health concerns should take a primary role in pandemic recovery. There has been a clear investment and prioritization of mental health by the leaders across our nation and our state. Allowing Oklahomans the ability to receive their care in an EmPATH unit will lead to clinically appropriate utilization of public and private mental health offerings which will produce improved patient outcomes at a reduced cost and ultimately healthier communities across the state of Oklahoma.

PERFORMANCE MEASURING

Project performance will be monitored through multiple outcome metrics including overall behavioral health emergency department length of stay, internal psychiatric bed utilization, inpatient psychiatric referrals, monitoring safety events in the emergency departments, and rates of restraint utilization. The data will be collected to ensure the project meets defined goals, including overall reduction in inpatient hospitalization, reduction in time spent in the emergency department, and increase in outpatient care referrals. Given the high rates of Medicaid coverage among this patient population, these metrics should also point to a reduction in the total cost to the state for each medical event.

ONGOING INVESTMENT AMOUNT

$

ONGOING INVESTMENT DESCRIPTION

None

ONGOING INVESTMENT REQUIRED

Able to continue operation without additional funding from the State of Oklahoma