03/17/2016

March President's Message

Two psychiatrists, three emergency physicians, two lobbyists, three executive directors, and one policy director walk into a bar...

Okay, so half of that was true. Sadly we did not meet at a bar.

Last week we held The Psychiatric Boarding in Ohio's Emergency Departments Summit, and by “Summit,” I mean some people got together on a random Thursday afternoon in the Ohio ACEP Board room and ate some Easter candy. Alright, I'll stop. This is what actually happened.

Since the Ohio Psychiatric Physicians Association shares our building, we thought we'd just schedule a meeting with them to fix the problem. Not surprisingly, their executive director agreed it's a huge issue for their members, too, but for reasons somewhat different than our own. After scheduling the meeting, we thought we should invite others as well to really start the discussion from all sides: emergency physicians, psychiatrists, and hospitals. And though we didn’t agree on every point discussed, everyone around the table was united on the most important point: psychiatric boarding is bad for our patients and needs to be addressed head-on.

Of course we didn't fix the problem in one afternoon. The point of the meeting was really just to listen to those present in order to better understand their concerns about the problem. I think it was an excellent first step towards addressing a complex issue that affects our patients throughout the state. We discussed the limited access to outpatient care for too many of our patients, which results in them coming to see us in the first place and prevents us from discharging them due to lack of follow-up. We also discussed bed shortages. I learned that Medicaid patients cannot be admitted to a for-profit outpatient psychiatric facility. This may soon be overturned at the federal level, but it would be some time before it could benefit our patients.

So that we have additional information to share at our next meeting, I'd really appreciate if you—our members—could share some data with me by answering a few quick questions about your emergency department and length of stays for admitted/transferred psych patients. I would also like to know, if you could change just one or two things in your ED or hospital to improve psychiatric length of stay, what would they be?

I look forward to your responses.

Best,

Michael

Michael McCrea, MD, FACEP
President, Ohio ACEP
mmccrea@ohacep.org