Presentation Title

Use of a Registered Nurse Case Manager for Psychiatric Patients in the Emergency Department

Faculty Mentor

Bharath Chakravarthy

Start Date

17-11-2018 2:30 PM

End Date

17-11-2018 2:45 PM

Location

C304

Session

Oral 3

Type of Presentation

Oral Talk

Subject Area

health_nutrition_clinical_science

Abstract

Behavioral health issues can contribute to difficulties in patient disposition while being seen in the Emergency Department (ED), which may continue to an increased length of stay in the ED potentially leading to poorer outcomes. From June 2014 to August 2014, the UCI ED employed a registered nurse psychiatric case manager to help handle the care and disposition of psychiatric patients as part of a quality improvement project. The purpose of this study is to analyze retrospective data from the electronic medical records (EMR) to see whether the use of a registered nurse case manager can help improve patient care in the psychiatric population. There will be three groups from which retrospective data will be collected. The primary group is patients who have been cared for by a registered nurse case manager from June 2014 to August 2014. The second group is patients with no case manager, which occurred 3 months prior to the registered nurse case manager was hired from March 2014 to May 2014. The third group is patients with a nonclinical case manager, which occurred in the 3 months after the registered nurse case manager was present from September 2014 to November 2014. The use of a registered nurse case manager for psychiatric patients in the ED may improve patient care when compared against no case manager or non-clinically trained case managers, as well as may streamline the discharge and disposition process, allowing for shorter lengths of stays for psychiatric patients within an ED Setting. Outcomes in this study will be measured based on total length of stay and the number of times physical or chemical restraints were used.

Summary of research results to be presented

Regarding preliminary progress reports, we have seen that Case managers only used for control of treatment plan tend to come in deal with patients who have minor psych complaints, such as feeling more depressed/ anxious lately, or would like their medication to be looked at. The cases in this cohort also had the shortest length of stay in the ED. However, the occurrence of only case managers in charge of the psych cases is a very small percentage. Secondly, there were many cases that have both psychiatric consults and case managers/ social worker consults managing their cases, and it seems that these patients tend to have greater psych complaints (such as Suicide with Plan, OD attempt, 5150/ 5585 for Gravely Disabled and Danger to others or Danger to Self), as well as stay in the ED for some of the longest times. This cohort of the data also has the greatest range in age, as there are patients in this cohort from the age of 12/13 up to the late 60s. Finally, the cohort in which only psychiatric consults manage the cases, seem to have pretty consistent length of stays, however they have widest chief complaints and ICD 9 codes when coming to the ED.

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Nov 17th, 2:30 PM Nov 17th, 2:45 PM

Use of a Registered Nurse Case Manager for Psychiatric Patients in the Emergency Department

C304

Behavioral health issues can contribute to difficulties in patient disposition while being seen in the Emergency Department (ED), which may continue to an increased length of stay in the ED potentially leading to poorer outcomes. From June 2014 to August 2014, the UCI ED employed a registered nurse psychiatric case manager to help handle the care and disposition of psychiatric patients as part of a quality improvement project. The purpose of this study is to analyze retrospective data from the electronic medical records (EMR) to see whether the use of a registered nurse case manager can help improve patient care in the psychiatric population. There will be three groups from which retrospective data will be collected. The primary group is patients who have been cared for by a registered nurse case manager from June 2014 to August 2014. The second group is patients with no case manager, which occurred 3 months prior to the registered nurse case manager was hired from March 2014 to May 2014. The third group is patients with a nonclinical case manager, which occurred in the 3 months after the registered nurse case manager was present from September 2014 to November 2014. The use of a registered nurse case manager for psychiatric patients in the ED may improve patient care when compared against no case manager or non-clinically trained case managers, as well as may streamline the discharge and disposition process, allowing for shorter lengths of stays for psychiatric patients within an ED Setting. Outcomes in this study will be measured based on total length of stay and the number of times physical or chemical restraints were used.