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Presenter John Baird Aged Persons Mental Health

Bed availability in aged mental health units and the impact of Emergency Department presentations: an escalation plan. Presenter John Baird Aged Persons Mental Health. National Mental Health Benchmarking Project 27 November 2008. Aged Persons Mental Health Program. Program consists of:

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Presenter John Baird Aged Persons Mental Health

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  1. Bed availability in aged mental health units and the impact of Emergency Department presentations: an escalation plan Presenter John Baird Aged Persons Mental Health National Mental Health Benchmarking Project 27 November 2008

  2. Aged Persons Mental Health Program Program consists of: • three acute inpatient units,(55 Beds) • three aged psychiatry assessment teams • and five residential accommodation facilities • (4 high care and 1 low care facility).

  3. History • Admission process. • Aged persons presentation at ED. • APMHP 08.00-16.30. • Interface with each other and adult services. • No escalation process

  4. Why an escalation plan • Aging population = ^ Aged related Illness = ^In aged accessing ED. = ^In demand for inpatient beds. • Structure of admissions to APMHP beds. • ECATT interface with ED and APMHP. • Adult services Escalation plan. • Number of 24 hour breaches continuing. • Impact on clinical Care. • Cultural change a “aged persons programme”

  5. What did escalation mean • DHS guidelines • Minimise the formation of queues • Traffic light system • Escalation of actions • Escalation ensure appropriate level of scrutiny • Leave beds • Held beds, absconders, medical treatment, EDM, residential beds, leave

  6. Four components • Traffic light escalation plan. • 8.00-4.30 ED flowchart. • After Hours flowchart. • Residential Escalation.

  7. What did we want to achieve! • A clearer interface between Emergency departments, Adult MH Services and APMHP(Including Residential Services). • A consistent approach across services. • Clarity of role for clinicians. • LOS/ Patient flow project. • Better consumer outcomes

  8. Data Taken from 2 timeframes • 1st May-30th Sept 2007 • 1st May-30th Sept 2008 Benchmark • All patients admitted to all three services ALOS Slightly increased from 41-44 days over these 2 periods. Admissions form ED • 5 month period 07 = 20 admissions • 5 month period 08 =13 admissions

  9. Data continued No of 24 hour Breaches in ED • 5 month period 07 = 3 • 5 month period 08 = 0 Average LOS for those admitted from ED • 5 month period 07 = 30 days • 5 month period 08 = 24 days

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