DCHA Abstract Competition Open

Submit Your Abstracts by July 8, 2024

The purpose of the Abstract Competition, as part of the 2024 Health Care & Innovation Summit (formerly known as the Patient Safety & Quality Summit) on October 30, is to stimulate systematic investigation by health care professionals, provide a venue to share innovative and effective programs, showcase unique projects, and encourage networking among peers with similar interests. The theme of this year’s Summit is Transforming Health Care: Lead. Collaborate. Improve.

1 Gold – $2,500
1 Silver – $1,500
1 Bronze – $1,000

December 2023 Utilization Report


Most utilization metrics saw a decrease from November to December with the exception of emergency department visits and psychiatric admissions. While ED visits present their highest volume in the past 15 months, ambulatory surgeries on the other hand saw their biggest decrease in volumes this month going from -4% below the pre-COVID baseline in November to -14% in December. Newborn admission saw a decrease in volumes this month and are now below the median and civil commitment admissions on the other hand remain above the median of 198 after the the dip in September 2023.


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Minority-Owned Business Enterprises: Transforming Health Care And Advancing Health Equity

Equity is defined as the absence of systemic disparities between groups with different levels of underlying social advantage/disadvantage—wealth, power or prestige. From voter suppression to housing discrimination, racial differences in health outcomes can be explained by centuries of policies and practices that have intentionally excluded nonwhite groups from access to opportunity. Moreover, inequitable practices baked into the “institutions” that shape society sustain seemingly intractable disparities in health.

The institutions of medicine and health care are no exceptions. But as discussed below, many minority-owned business enterprises (MBEs) are challenging the status quo in health and health care, advancing health equity in transformative ways, and bridging the gap between health care and the many social factors that occur outside of care settings but have a huge impact on health.

Authors: Dr. Christopher King, Dean of School of Health, Georgetown University Medical Center and Deliya Banda Wesley, Senior Director of Health Equity, Mathematica

The Cost of the Status Quo: The Consequences of Prolonged Emergency Department Boarding

Op-ed written by Shana Palmieri, LCSW, Chief Clinical Officer and Cofounder, XFERALL


The Washington Post recently published the article ‘An autistic teen needed mental health help. He spent weeks in an ER instead.’ It is beyond distressing to hear repeated stories about the suffering of patients and families like Zach’s, spending days and in this case months in the emergency department waiting for a transition to behavioral health treatment.

As health care providers and administrators, you have likely faced the challenge to ensure timely access to behavioral health services for patients like Zach experiencing a crisis. The health care team working around the clock to facilitate better referrals and placement for clinically appropriate care to meet their needs. Often this is met with challenges, outdated processes and limited options to which this article provides an insight to.  These stressful situations impact everyone involved, the patient, the family, caregivers, and the entire care team.

Speaking from my own experience, many of us have walked into our emergency departments with patients lined up on stretchers needing behavioral health crisis services waiting for hours and days for placement. The challenge is nationwide, with patients languishing in the emergency department causing a myriad of operational and quality of care challenges. Meanwhile the  consequences of emergency department boarding of psychiatric patients present increased risk often leading to negative outcomes that are distressing, traumatic, or potentially life-threatening. The consequences of maintaining the status quo without a systemic intervention to drive improvements spreads across multiples domains.

Quality Patient Care, Safety & Risk Management 

Psychiatric patients boarding in the emergency department increases risk events for the patient themselves, health care professionals and other patients presenting to the emergency department for acute medical conditions. As emergency departments reach their capacity limits, staff are stretched thin sometimes resulting in increased risk events. Quality of care is impacted for all patients because of obstacles to efficient throughput. The entire health care system can become bottlenecked, patient care suffers and at times safety is compromised.

Workforce Inefficiencies and Shortages

The health care industry is amid a critical health care workforce shortage. According to the 2022 NSI National Healthcare Retention & RN Staffing Report, the average hospital turnover rate is now 25.9% – an increase of 6.5%.

During this challenging workforce shortage, highly trained healthcare professionals have to follow manual processes to coordinate care by making repeated phone calls and faxing to find an available behavioral health placement, while delays and patient care is waiting. Hours and hours of precious staff time is wasted on an inefficient process when the opportunity to use resources to automate and improve productivity drastically reducing emergency boarding times is available.

Lost Opportunity and Cost 

The cost of psychiatric emergency department boarding to health system’s is significant. Delayed care leads to poor outcomes and emotional stress felt by staff and patients. Additionally there are financial implications when these scenarios become the norm. Health systems may have to limit their ability to treat and admit higher acuity medical patients. This right sizing for facilities is critical to ensure all services can continue to be provided for communities.

Extended behavioral health boarding costs occur when clinicians are searching for bed placement, for example a mid-sized acute-care hospital were transferring on average 90 behavioral health patients a month. This process took on average over 8 hours per patient to find an appropriate transfer for a bed placement That equated to over 720 hours per month just in staff time to find placement. At the estimated cost of $250 an hour to board a behavioral health patient in the emergency department (includes cost of care and opportunity lost) those 720 hours is equal to a loss of $180,000 per month or $2,160,000 per year. This hospital automated the bed placement process and today their average time to find a bed is under 55 minutes. With these changes the same 90 patients now cost the system only $22,500 per month or $270,000 per year.  That is a cost savings of $1,890,000 annually.

Changing the Status Quo 

The cost of maintaining the status quo is significant. Change is hard. We consistently ask our patients to make significant, difficult, life transforming changes to improve their health, improve their mental health symptoms and eliminate their addictions. Healthcare systems, clinicians and administrators also must engage in this type of proactive change to reap the positive benefits in the years to come.  The cost is too high to keep things the way they are for patients, for families, for health care providers and for the health care system.

A Behavioral Health Automated Transfer Network is available in the District of Columbia and surrounding states.  The automated network offered through XFERALL, a web-based platform with companion mobile application, is available to healthcare systems, first responders, mobile crisis teams and local crisis providers. Working together, standing up an  network, expediting transfers, and using real-time data to drive continuous quality improvement will lead us one day at a time away from the challenges, excess cost, and negative patient and healthcare provider experience and into a future that drives consistent improvements in quality patient care, decreases risk events, improves safety, provides transparent data to enhance regional capacity, addresses staff safety, and improves access to care that ensure patients and families similar to Zach’s have immediate access to quality care.


XFERALL Gedrags-gezondheidssamenwerking en 988 Crisis

Decennialang werd algemeen aangenomen dat mensen die een medisch noodgeval ervaren, niet op behandeling moeten wachten. Richtlijnen voor de behandeling van personen met hartaanvallen, beroertes en traumatische verwondingen geven prioriteit aan snelle respons. De medische gemeenschap verwijst naar het "gouden uur" - de 60 minuten waarbinnen een gewonde of zieke persoon definitieve behandeling moet krijgen vanaf het moment van verwonding of het begin van symptomen. Als de zorg na dit uur wordt uitgesteld, neemt het risico op ernstige, langdurige complicaties of overlijden aanzienlijk toe. Er ontstonden nieuwe zorgsystemen, vaak geregionaliseerd, om ervoor te zorgen dat er geen kostbare tijd verloren gaat bij het vervoeren, stabiliseren, behandelen en overbrengen van patiënten.

Maar voor mensen die een psychiatrisch noodgeval of een noodsituatie ervaren, heeft een vergelijkbare urgentie in combinatie met systeemverandering niet de overhand gehad. Zelfs in 2022 moeten te veel ziekenhuizen, crisisteams, eerstehulpverleners en anderen die mensen snel een gedragsmatige gezondheidsbehandeling moeten geven, vertrouwen op verouderde, handmatige processen om klinisch geschikte zorg te vinden, wat kritieke vertragingen in de zorg veroorzaakt. In hun zoektocht naar plaatsing bellen clinici één voor één naar gedragsgezondheidsinstellingen en -programma's, laten ze berichten achter, faxen papierwerk en wachten tot ze worden teruggebeld. De schijnbaar eenvoudige handeling van het overdragen van een patiënt naar gedragsmatige gezondheidszorg vereist dat clinici talloze uren besteden aan repetitieve administratieve taken die hen wegnemen van directe patiëntenzorg.

Het resultaat is dat, veel te vaak, kinderen, adolescenten en volwassenen die een gedragscrisis ervaren, uren of zelfs dagen wachten op plaatsing in een klinisch geschikte therapeutische behandeling. Eén studie documenteert een gemiddelde verblijfsduur op de afdeling spoedeisende hulp van een ziekenhuis voor psychiatrische opnames van 18 uur, vergeleken met 5 uur voor niet-psychiatrische opnames.1 Anderen schatten de gemiddelde verblijfsduur tussen 6,8 uur en 34 uur voor patiënten die psychiatrische behandeling nodig hebben. 2,3

Tegenwoordig zijn deze wachttijden waarschijnlijk nog langer, omdat de pandemie de ED-instapcrisis op twee manieren heeft verergerd. Ten eerste zitten ziekenhuizen op of boven hun capaciteit met patiënten met COVID-19 en andere ernstige fysieke aandoeningen in combinatie met een steeds groter wordend personeelstekort. Twee, de pandemie, en de daarmee gepaard gaande angst, stress en isolatie, hebben bijgedragen aan een toegenomen behoefte aan gedragsmatige gezondheidszorg, vooral bij kinderen en adolescenten. Naar verluidt zagen kinderziekenhuizen tussen januari en juli 2021 een stijging van 45 procent van het aantal gevallen van zelfverwonding en zelfmoord bij kinderen. .5

De missie van XFERALL is om drastisch tijd te besparen voor klinisch personeel en de hoeveelheid tijd die patiënten doorbrengen op SEH's te verminderen die wachten op een transfer naar het meest geschikte zorgcentrum door innovatieve technologische oplossingen toe te passen. Het platform maakt realtime communicatie mogelijk, zodat clinici die een patiënt moeten plaatsen, plaatsing kunnen aanvragen bij zo weinig of zo veel faciliteiten als ze willen; reacties ontvangen van faciliteiten of programma's die de patiënt kunnen accepteren en behandelen; en deel klinische informatie - allemaal binnen enkele minuten en binnen één enkele bron. Door deze gecoördineerde aanpak kunnen zorgverleners en patiënten ook worden betrokken bij het besluitvormingsproces.

De District of Columbia Hospital Association en XFERALL, 's lands toonaangevende platform voor mobiele patiëntoverdracht, zijn een samenwerking aangegaan die ziekenhuizen in DC een nieuw proces biedt voor het overbrengen van acute en gedragsmatige gezondheidspatiënten naar klinisch geschikte zorginstellingen. Kom voor meer informatie op 10 mei naar een gratis webinar, Gedragsgezondheid Patiëntoverdracht en plaatsingstechnologie, en leer over dit programma en hoe het de toegang voor patiënten in crisis kan verbeteren.

XFERRAL Webinar Graphic

1 Nicks BA, Manthey DM. De impact van de opname van psychiatrische patiënten op de spoedeisende hulp. Emerg Med Int 2012; 2012: 360308.

2 Weiss AP, Chang G, Rauch SL, et al. Patiënt- en praktijkgerelateerde determinanten van de opnameduur op de SEH voor patiënten met een psychiatrische aandoening. Ann Emerg Med. 2012;60(2):162–71.

3 Tuttel GA. Toegang tot psychiatrische bedden en impact op spoedeisende geneeskunde. Chicago, IL: Raad voor Medische Dienst, American Medical Association; 2008.

4 Kinderartsen, kinder- en jeugdpsychiaters en kinderziekenhuizen verklaren nationale noodtoestand in de geestelijke gezondheid van kinderen, 19 oktober 2021.

aacap.org/aacap/zLatest_News/Kinderartsen_CAPs_Childrens_Hospitals_Declare_National_Emergency_Childrens_ Mental_Health

5 Ibid

ONE-DC: Wie zijn wij

ONE DC is a non-profit organization consisting of nurse leaders and nurses aspiring to be leaders. This includes nurses from all settings and specialties, who hold positions as nurse executives, administrators, nurse managers, nurse educators, nursing quality managers, nursing staff leaders and researchers from across the District of Columbia. The organization addresses the nursing workforce, administration, education, evidence-based practice, research, health policy, and professional practice issues.

ONE DC Officers:

Laura Hendricks-Jackson – Interim President/Treasurer
CNO, Sibley Memorial Hospital

Hazel Darisse – Secretaris
Assistant CNO, The George Washington University Hospital

April is National Donate Life Month

April is National Donate Life Month, a time to encourage people to register as organ, eye and tissue donors and to celebrate those that have saved lives through the gift of donation.

Across the U.S., there are more than 112,000 patients on the national transplant waiting list who need a kidney, heart, lungs, pancreas, liver, or intestine. Thousands more need tissues such as corneas to restore sight, skin to heal burns, heart valves to repair defects, bones to correct injuries and tendons/ligaments to restore movement.


       Malkia White

Currently, there are more than 2,200 patients in the D.C. metropolitan area waiting for a lifesaving transplant. Patients like Malkia White who was diagnosed with kidney disease when she was a young girl. She successfully managed her disease most of her life, until a few years ago, when her kidney function went into rapid decline. Malkia, who is now on the waiting list for a new kidney, relies on dialysis treatment three nights a week to keep her alive.

Washington Regional Transplant Community (WRTC), the local non-profit organ procurement organization responsible for facilitating donation process, has a longstanding relationship with hospitals in D.C. Thanks to its hospital partners, WRTC recovered and allocated 485 lifesaving organs from 145 generous donors in 2019, saving the lives of 417 individuals. In addition, WRTC also recovered tissues from 462 benevolent donors, whose precious gifts could enhance the lives of nearly 35,000 people.

Be part of the miracle. During National Donate Life Month, give people like Malkia hope by registering to be an organ, eye and tissue donor at BeADonor.org.


© 2024. District of Columbia Hospital Association.