标签存档: 转移

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XFERALL 行为健康合作方法和 988 危机

For decades, it has been commonly understood that individuals experiencing a medical emergency shouldn’t wait for treatment. Treatment guidelines for individuals experiencing heart attacks, strokes and traumatic injuries prioritize rapid response. The medical community refers to the “golden hour” — the 60 minutes within which an injured or sick person should receive definitive treatment from the time of injury or onset of symptoms. If care is delayed beyond this hour, the risk of serious, long-term complications or death significantly increases. New systems of care, often regionalized, emerged to ensure that no precious time is lost in transporting, stabilizing, treating, and transferring patients.

Yet, for people experiencing a psychiatric or substance use emergency, a similar urgency coupled with system change hasn’t prevailed. Even in 2022, too many hospitals, crisis teams, first responders, and others needing to get people into behavioral health treatment quickly must rely on outdated, manual processes to locate clinically appropriate care, which cause critical delays in care. In their search for placement, clinicians are calling behavioral health facilities and programs one-by-one, leaving messages, faxing paperwork, and waiting for calls to be returned. The seemingly simple act of transferring a patient to behavioral health care is requiring clinicians to spend countless hours on repetitive administrative tasks that take them away from direct patient care.

The result is that, far too often, children, adolescents, and adults experiencing a behavioral health crisis wait hours or even days for placement in clinically appropriate therapeutic treatment. One study documents an average length of stay in the hospital emergency department for psychiatric admissions of 18 hours, compared to 5 hours for non-psychiatric admissions.1 Others have estimated average boarding times of between 6.8 hours and 34 hours for patients needing psychiatric treatment.2,3

Today, these wait times are likely even longer as the pandemic has made the ED boarding crisis worse in two ways. One, hospitals are at or beyond capacity with patients with COVID-19 and other serious physical conditions coupled with ever increasing staffing shortages. Two, the pandemic, and the associated anxiety, stress, and isolation, have contributed to an increased need for behavioral health care, particularly among children and adolescents. Children’s hospitals reportedly saw a 45 percent increase in pediatric self-injury and suicide cases between January and July 2021.4 In 2020, pediatric mental health-related hospital emergency department visits increased 24 percent for children ages 5-11 and 31 percent for older children and adolescents.5

XFERALL’s mission is to drastically save time for clinical staff and reduce the amount of time patients spend in EDs waiting for a transfer to the most appropriate care center by applying innovative technology solutions. The platform enables real- time communication so that clinicians needing to place a patient can request placement at as few or as many facilities as they choose; receive responses from facilities or programs that can accept and treat the patient; and share clinical information — all within minutes and within a single source. This coordinated approach allows caregivers and patients to be engaged in the decision-making process as well.

The District of Columbia Hospital Association and XFERALL, the nation’s leading mobile patient transfer platform, have entered a partnership that offers DC hospitals a new process for transferring acute and behavioral health patients to clinically appropriate health care facilities. To learn more, join us on May 10 for a free webinar, 行为健康患者转移和安置技术, and learn about this program and how it can support improving access for patients in crisis.

XFERRAL Webinar Graphic

1 Nicks BA, Manthey DM. The impact of psychiatric patient boarding in emergency departments. Emerg Med Int 2012; 2012: 360308.

2 Weiss AP, Chang G, Rauch SL, et al. Patient and practice-related determinants of emergency department length of stay for patients with psychiatric illness. Ann Emerg Med. 2012;60(2):162–71.

3 Tuttle GA. Access to psychiatric beds and impact on emergency medicine. Chicago, IL: Council on Medical Service, American Medical Association; 2008.

4 Pediatricians, Child and Adolescent Psychiatrists and Children’s Hospitals Declare National Emergency in Children’s Mental Health, October 19, 2021.

aacap.org/aacap/zLatest_News/Pediatricians_CAPs_Childrens_Hospitals_Declare_National_Emergency_Childrens_ Mental_Health

5 Ibid

即使在大流行期间也能减少 ED 董事会时间并改善安置

美国急诊医师学院 (ACEP) 去年 8 月将医院急诊科患者的登机时间确定为“历史最高水平”。这适用于所有等待转移到不同设施进行所需治疗的患者,无论是行为健康设施还是提供更高水平急性护理的医院。

ACEP 确定了增加登机时间的两个原因:1) 医院人员短缺和 2) 患有 COVID-19 和其他紧急情况的重症患者涌入,部分原因是患者在大流行期间延迟了必要的医疗护理。

对于需要行为健康治疗的患者,即使在 COVID-19 大流行之前,急诊医院急诊科的平均等待时间 保守地 估计是八小时。然而,有趣的是,全国各地的医院经常报告临床上合适的等待时间要长得多,可用的精神病床很难确定,特别是对于某些人群,如儿童和青少年、老年患者以及同时患有疾病的人。

今天,就在 ACEP 提出对历史最高登机时间的担忧仅仅五个月之后,这个问题变得更加严重,因为该国正在经历更多的 COVID-19 病例,这是由 Omicron 变体推动的,而且人员配备更加紧张短缺。

对于医院使用 XFERALL 为了自动化和加快急性医疗和行为健康患者转移,情况并不那么黯淡。仅在德克萨斯州,2020 年 8 月至 2021 年 7 月期间使用 XFERALL 转移医疗患者的医院在不到 1 分 18 秒内就收到了接收医院对其转移请求的响应,并在不到 20 分钟的时间内确保接受患者转移。在过去两年中,即使在大流行期间,XFERALL 的合作伙伴也将行为健康患者的转移时间减少了 86%。

XFERALL 使医疗保健系统和提供者能够快速确定有能力接受患者进行转移的医疗和行为医院。 XFERALL 技术使患者转移过程自动化,减少了医疗保健提供者的工作量,并通过减少转移时间提高了急诊科的能力。通过使患者转移过程自动化并提高对更广泛的潜在可用床位网络的可见性,XFERALL 消除了护士和其他临床医生拨打劳动密集型电话和传真的需要,以便为需要转移的患者确定临床上适当的护理。

国家的医疗人员配备危机没有简单的解决办法,COVID-19 的终结仍然难以捉摸。好消息是,尽管如此,医院仍可以通过实施内部后勤和运营来加速患者有效和高效地过渡到适当的治疗,从而减少护理延误并减轻人员短缺的后果。改进始于质疑拿起电话和传真临床信息的旧习惯,并对患者转移过程的现代化持开放态度。从来没有像现在这样紧迫。

要了解有关与 DC 地区医院和行为健康团队合作的更多信息,请联系政府事务和政策高级副总裁 Jennifer Witten,网址为 Jennifer.Witten@xferall.com.

© 2024. District of Columbia Hospital Association.