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Beyond Boarding: A New Paradigm for Behavioral Health in the Emergency Department

White Papers

Individuals with mental health or substance-use related issues are one of the fastest growing patient populations in U.S. hospital emergency departments. Between 2006 and 2014, this population experienced a 44% increase in emergency department (ED) visits.

This surge is creating a crisis for some hospitals. Without adequate access to behavioral health specialists to perform mental health evaluations or readily available psychiatric beds for admission, these patients often hold or “board” for hours, days and even longer, often without receiving the specialized psychiatric care they need. While these patients wait, their conditions may be exacerbated by the isolation of a private room or the loud and chaotic environment of an ED hallway. In addition, by occupying beds that might otherwise be taken by patients with physical medical conditions, these patients can inhibit patient flow, extend wait times and contribute to ED diversions.

There are a multitude of factors that have led to this situation, and hospitals cannot solve the problem alone. They can, however, make some fundamental changes to the way they approach and treat patients with behavioral health conditions while boarding in the ED to improve their care and, concurrently, expedite patient flow. This white paper discusses a new approach to treating behavioral health patients in the ED.

To read more, please download the pdf version of this white paper below.