Empowering our EDs to Deliver Compassionate Behavioral Healthcare

Published December 10, 2018

As Featured in HealthLeaders



At a time when healthcare conversations focus on cost reductions and value-based payment models, discussions about solutions for our overburdened emergency departments (EDs) are often sidelined.

In this interview, Vituity’s Chief Medical Officer, Gregg Miller, MD, shares his perspectives on how EDs can reinvent themselves and deliver improved outcomes to all patients through an integrated and collaborative approach to acute behavioral healthcare.


What has changed, why are EDs in the U.S. busier than ever before?


Dr. Miller: A primary reason is the increased demand for emergency services. ED teams deliver nearly half of all U.S. hospital-based medical care, more than 140 million annual visits. Meanwhile, the number of hospitals, hospital beds, and EDs has declined significantly. This has stretched resources beyond capacity which impacts the quality of patient care.


Adding to this pressure is the growing number of patients presenting to the ED with behavioral health emergencies. In the last ten years, this number has more than doubled to roughly 12 percent of all ED visits, and in many communities the number is much higher. This increased need for specialized ED care, and the strained resources typically available, has deep repercussions for hospitals and health systems.


How are EDs handling the growing volume of behavioral health patients?


Dr. Miller: It’s a challenge. ED teams know the steps to follow when dealing with physical emergencies, but most are not sufficiently trained to effectively care for patients with behavioral health conditions. All too often, the process for treating behavioral health patients is not clinically integrated, and providers are unprepared and unsure of the right course of action. This results in poorer clinical outcomes and a diminished patient experience.


What is being done to help fix this gap in care?


Dr. Miller: We have seen tremendous improvements over the past fifteen years, but there are still more mountains to climb and more work to be done to create solutions that serve the needs of all our patients. At the end of the day, as care providers, we are only as good as the systems where we practice.


What’s needed now is an approach that fosters collaboration between care delivery teams in the ED, empowering them to properly evaluate and treat all patients, including those experiencing a psychiatric emergency, from the moment they enter the ED through discharge.


How is Vituity helping EDs solve these challenges?


Dr. Miller: We have been reinventing emergency medicine to better serve patients since our founding, nearly 50 years ago. Today, we are excited about our new solution that integrates emergency and acute psychiatric care. Our front-line physicians and behavioral health clinicians work with existing ED teams, preparing them to be ready for all emergencies – behavioral and physical.


The core of this solution is deep expertise in emergency department and psychiatric care delivery, linked by a comprehensive training program that delivers depth and context for the treatment of acute behavioral health conditions. Our training program covers the latest protocols for de-escalation, agitation, and restraint management, plus psychiatric and opioid medication management.


In addition, our coaching and leadership development programs solidify integration and affect positive cultural and operational change. Our expert clinicians utilize the latest care delivery tools, including telepsychiatry and EmPath units. These innovations help to personalize the treatment and care experience of behavioral health patients, with quick and accurate diagnoses as well as a calming setting. We also ensure coordinated treatment planning through an in-hospital psychiatrist presence dedicated to the admitted patient population.


What are the results of an integrated care delivery approach?


Dr. Miller: The positive impact for hospitals and patients is phenomenal. We’ve seen providers gain new confidence in their ability to heal and find joy in their practice. And most importantly, we’ve seen patients recognize that on a very human level they’re being properly cared for with dignity and respect.

Vituity’s culture is all about innovation and collaboration, and we use that to transform care delivery in more than 250 practice locations. We believe that empowering EDs to reinvent themselves and provide a higher standard of acute behavioral healthcare delivers improved outcomes for all patients.


Gregg Miller, MD, is Chief Medical Officer for Vituity. This article originally appeared in Health Leaders Media.

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