Lester Natalie A, Thompson Laura R, Herget Kendal, Stephens Julie A, Campo John V, Adkins Eric J, Terndrup Thomas E, Moffatt-Bruce Susan
1 The Ohio State University Wexner Medical Center, Columbus, OH.
Am J Med Qual. 2018 Jan/Feb;33(1):65-71. doi: 10.1177/1062860617696154. Epub 2017 Mar 1.
Emergency departments (EDs) have seen rising numbers of patients in psychiatric crises, patient boarding, and throughput delays. This study describes and evaluates the impact of a Crisis Assessment Linkage and Management (CALM) service designed to manage behavioral health crises. A year-to-year comparison was performed before (n = 2211 ED visits) and after implementation of CALM (n = 2387). CALM was associated with reductions in median ED and hospital length of stay (LOS) from 9.5 to 7.3 hours and 46.2 to 31.4 hours, respectively. Mean transformed ED LOS decreased by 32.4% ( P < .001). The CALM model improved patient care and throughput metrics by proactively managing behavioral health crises.
急诊科接待的处于精神危机、患者滞留及流转延迟状态的患者数量不断增加。本研究描述并评估了一项旨在管理行为健康危机的危机评估联动与管理(CALM)服务的影响。在CALM实施之前(n = 2211次急诊科就诊)和实施之后(n = 2387次)进行了逐年比较。CALM与急诊科和医院中位住院时长(LOS)的缩短相关,分别从9.5小时降至7.3小时,从46.2小时降至31.4小时。急诊科平均转化住院时长减少了32.4%(P < .001)。CALM模型通过主动管理行为健康危机改善了患者护理及流转指标。