Despite making up more than 12% of all emergency department visits, many behavioral health patients board in the emergency department, waiting for a bed that is difficult to find and likely unnecessary. These chaotic conditions raise the anxiety level for both patients and providers, degrading the care experience for all emergency department patients.
Emergency Psychiatric Intervention (EPI) is an approach and toolkit designed by Vituity physicians on the front lines of emergency medicine and acute psychiatry. EPI ensures that emergency departments are empowered to effectively evaluate and treat behavioral health patients from the moment they enter the emergency department.
“If behavioral health emergencies could be handled as effectively as physical ones, it would dramatically change the quality of care and the economics of our emergency departments.”
Scott Zeller, MD
Vice President of Acute Psychiatry, Vituity
EPI creates core efficiencies to assess, evaluate, and treat behavioral health patients. The approach includes expertise and proven results in three areas:
Elimination of over-processing
Through the elimination of unnecessary roadblocks to expedite treatment, patients receive earlier assessments and differentiated care based on diagnosed need.
Risk stratification and split flow processing
EPI’s risk stratification tools allow clinicians to bypass unnecessary care steps (e.g., bloodwork) for low-risk patients. This improves time-to-discharge and frees up staff resources for moderate- and high-risk cases.
Early and appropriate medication management
EPI’s medication protocols promote use of second-generation antipsychotics. These medications are less sedating than older antipsychotics and therefore don’t require extended emergency department stays. Clinicians also began offering medications earlier and in oral formulations, further reducing over-sedation and coercion.
To implement EPI, Vituity brings together clinical teams from multiple emergency departments in a collaborative learning program. Participants included medical, nursing, case management, and social work leaders from each participating emergency department. During a six-month program, the teams are provided comprehensive training on the treatment of behavioral health conditions, leadership coaching, introduction to EPI toolkits on de-escalation, risk stratification and medication protocols, as well as onsite visits from Vituity faculty.
For Clinicians and Staff
For Health Systems
SPOTLIGHT TOPIC IN ACTION
EPI in Action: CommonSpirit Health
CommonSpirit Health implemented EPI in nine emergency departments via a six-month Collaborative. The program resulted in a number of improvements across the participating hospitals: