By Jessica Zigmond
Modern Healthcare
Originally published on May 26, 2013
Borderline personality disorder. Schizophrenia. Psychotic tendencies. Suicidal behaviors. Typically found in the caseload of an inpatient psychiatric facility, these conditions have become prevalent in another area of the U.S. healthcare system: the acute-care hospital emergency department.
In 2006, an Institute of Medicine report concluded hospital emergency rooms are overwhelmed, citing increases in lengths of stay for patients seeking care, crowding of existing ER space and boarding of patients who need an inpatient bed as the reasons.
And a recent study published online in the Annals of Emergency Medicine shows that psychiatric patients spent more than 11 hours in the ER, on average, when they sought care. According to the recent findings, the need for hospitalization, use of restraints and completing diagnostic imaging led to more time after a patient was assessed, while the presence of alcohol on toxicology screening caused delays earlier in ER stay.
“Basically, the ER has gone from an emergency room to a place where all of society's problems show up,” says Dr. Nicholas Vasquez, an emergency services physician at St. Joseph's Hospital and Medical Center in Phoenix, who did not speak on behalf of the hospital. “And one of those is mental health issues.”
A noisy, chaotic place isn't the appropriate setting for patients who require stability and quiet, says Vasquez, past president of the Arizona College of Emergency Physicians. As he explains, the 60-bed emergency department where he works expands and contracts throughout the day and includes an average of three to four psychiatric patients daily.
The entire story is reprinted here.
