Emergency Department Models of Care 2012 - NSW Health

More documents

Recommendations

Info

4.4 Psychiatric Emergency Care Centre ServicesWhat is the model?Psychiatric Emergency Care Centre (PECC) services aim to provide timely access to specialisedmental health care for people presenting to the hospital ED that have an acute mental healthillness or disorder, or for people with co-morbid substance abuse.The PECC also aims to provide:■■■Safety for consumers, service providers, and the publicAdvice and education for general ED staffAppropriate support for other service providers (including Police and the AmbulanceService).PECC services have been developed in response to the move from stand alone institutions tomainstream mental health services in general hospitals, making emergency departments aprimary entry point to mental health care.PECC services operate as an extension to the mental health ambulatory triage andassessment service offered by existing Consultation Liaison (CL) Psychiatry services, mentalhealth CNC ED services and liaison mental health nurse practitioners. They extend theseservices by offering:■■■■A permanent presence in Emergency DepartmentsFull clinical assessment at the point of intake, and treatment and active dischargeplanning from the outsetIncreased capacity to manage behavioural disturbances in EDBed capacity for overnight and short stay (< 48 hrs) for consumers who do not requireintensive or longer stay inpatient mental health care.For further information, visit the NSW Ministry of Health Mental Health web links:ED Mental Health:http://internal.health.nsw.gov.au/pubs/2009/pdf/mh_emergency.pdfMental Health Assertive Patient Flow:http://www.archi.net.au/documents/resources/models/mhapf/patient-flow.pdfCaring for Mental Health Patients:http://www.archi.net.au/resources/chronic/care/mh-redesignWhy use the model?The PECC model represents an alternative short stay or acute care environment and transitionpoint for mental health services between community care and inpatient care.PECC services provide two key functions:■■A 24/7 mental health staff presence in Emergency DepartmentsA small 4–6 bed inpatient unit located in close proximity to the Emergency Departmentto provide short-term observation and care.PAGE 56 NSW HEALTH Models of Emergency Care
Mental Health LiaisonNursesApproximately 60 mental health Clinical Nurse Consultants (CNC) and mental health nursepractitioners are now operating in rural and metropolitan hospitals offering both ambulatorymental health assessments to Emergency Departments and consultation liaison support togeneral hospitals. These nurses also provide education and direct clinical care (triage,assessment, treatment).The balance of functions for Mental Health Liaison Nurses varies between hospital sites. Inlarger hospitals they may be part of a broader Consult Liaison Service. In most sites thisservice operates Monday to Friday between 8am and 5pm.The majority of hospitals at delineation level 3 and above are also funded to provide mentalhealth staff 16 hours per day and on-call overnight to coordinate community emergencymental health responses. This includes assisting the Ambulance Service and Police to accessappropriate care. Many of these funded positions are allocated to or also support the localPECC or Consult Liaison functions.Benefits of the model ■ Staff with the appropriate skills are available to provide effective and timely outcomes formental health consumers, and are more closely aligned to ED demand■■Improved relationships with Mental Health Services and ED cliniciansImproved access to care for mental health consumers in the ED.Case for implementationTo assess the need to implement this model to support your ED, consider the following:■■■■Does your ED experience inefficient patient flow?Do mental health patients experience delays in accessing appropriate care and anextended length of stay in ED?What is the proportion of mental health admissions from your ED?Is your Hospital meeting 4-hour national emergency access targets?Monitoring andevaluation■■■■■■■% of ED patients with an ED LOS < 4 hoursNumber of mental health presentations to the ED% of mental health patients with an ED LOS < 8 hoursTime to mental health assessment/consultationLOS in PECC% discharged to home from PECCReadmission rate within 28 days of PECC discharge.Models of Emergency Care NSW HEALTH PAGE 57
Page 2 and 3:
NSW MINISTRY OF HEALTH73 Miller Str
Page 4:
Executive SummarySince the publicat
Page 7 and 8: 1.2 A review of Emergency Modelsof
Page 9 and 10: ■■■patients who need only a s
Page 11 and 12: SECTION 3Emergency Department Model
Page 13 and 14: In determining your skill mix requi
Page 15 and 16: Benefits of the model ■ Improved
Page 17 and 18: 3.2 Clinical Initiatives NurseResus
Page 19 and 20: ■■Demonstrated ability to inter
Page 21 and 22: Predictive planning■■■■■
Page 23 and 24: 3.4 Acute Care2 hoursED Senior Asse
Page 25 and 26: What you need to runthe modelStaff
Page 27 and 28: Key principles ■ This is not a st
Page 29 and 30: Monitoring andevaluation■Waiting
Page 31 and 32: Challenges ■ Establishing guideli
Page 33 and 34: 3.7 Fast trackED Senior Assessment
Page 37 and 38: 3.8 Sub-acute2 hoursED Senior Asses
Page 39 and 40: 3.9 2 : 1 : 12:1:1This model requir
Page 41 and 42: Monitoring andevaluation■■■
Page 43 and 44: Why use the model?Key principlesBen
Page 47 and 48: SECTION 4Streamlining access to acu
Page 49 and 50: Challenges ■ Identification of
Page 51 and 52: ■■■Patient Flow pathways and
Page 53 and 54: Case for implementationWhat you nee
Page 55 and 56: Operating Principles■■■■■
Page 57: Case for implementationWhat you nee
Page 61 and 62: 5.1 Urgent Care CentreThe Urgent Ca
Page 63 and 64: 5.3 Connecting CareWhat is the mode
Page 65 and 66: SECTION 7Self-Assessment ToolsInclu
Page 67 and 68: NHS Gloucestershire 2006, UK Urgent
show all

Emergency Department Models of Care 2012 - NSW Health

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?