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How safe is your emergency department for behavioral health patients and staff?

June 18, 2014
by James M. Hunt, AIA
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Practical strategies and solutions to reduce the risks, improve efficiency and increase patient satisfaction.

In recent years, healthcare organizations have experienced a growing number of patients with behavioral health issues presenting in their Emergency Departments.  This has created the following challenges for many hospitals.

1.    Many facilities do not have a sufficient number of treatment rooms which are safe to use for these patients which causes them to perform the time consuming process of removing as many potentially hazardous items from the rooms as possible.  These items need to be stored somewhere while the behavioral health patient is in the room and then returned to the room after the patient is discharged from the department.  This requires a lot of staff time and keeps the room from being available for other patients for an extended period.  Providing "swing" rooms that can be quickly adapted to eliminate many potential hazards can greatly reduce the time and cost impact of these issues.

2.    Behavioral health patients can often be very loud and create significant disturbances that may be upsetting to other patients and their families.  Therefore, it is helpful if these patients can be grouped together.  This may also be helpful in reducing the number of one-to-one observers required for a given number of patients if the rooms are arranged appropriately.

3.    Behavioral health patients tend to be in the emergency department for 8 hours or longer waiting for transportation or admission to a treatment facility.  This occupies a treatment room for the entire time and prevents it from being available to other patients.  The provision of an observation area for patients awaiting test results, transportation or room assignments can make the treatment rooms available for other patients.

4.    There are often no toilet rooms available that are designed for safe use by behavioral health patients.  It may be possible to modify the existing toilet rooms for safe use by all patients at minimal cost.

Addressing these issues with an experienced design team can significantly increase the level of safety (for both patients and staff) in existing Emergency Departments at a realistic cost that may have a very short payback period due to increased revenue from a more efficient use of both staff time and utilization of the rooms available.  The resulting space will also yield higher levels of patient satisfaction from both the behavioral health patients and the other patients sharing the emergency department.



Jim Hunt

Behavioral Healthcare Design Consultant

Jim Hunt

James M. Hunt, AIA, is a practicing architect and facility management professional with over 40...

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