Police Ambulance Early Access to Mental Health … · Detective Acting Superintendent Wayne...
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Acknowledgements Leanne Johnson General Manager, Mental Health (Sponsor) Detective Superintendent Chris Craner & Detective Acting Superintendent Wayne Humphrey NSW Police Force (Sponsor) Chief Superintendent Jeff Hescott NSW Ambulance (Sponsor) Mel Willis/Nicole Manning, Redesign Leads Emergency staff who participated in interviews/process mapping meetings Patients/Carers who participated in interviews Mental Health Contact Centre staff who participated in process mapping meetings Liz Bosworth, Volunteer Manager, HNELHD MH Services Samuel Smith, MH Volunteer and Consumer Front Line Police and Paramedics Conclusion The PAEAMHATH project has shown that working in collaboration creates a platform that best meets the needs of patients. PAEAMHATH facilitates a culture of person-centred care that incorporates the needs of families and carers. The PAEAMHATH project will enhance the ability of Police, Ambulance and Health Services to deliver Mental Health care throughout Australia, however the project is expected to provide the most benefit in the more regional, rural and remote areas of the country where patients do not have access to or choice of Mental Health care. Case for change When a patient is having a Mental Health (MH) crisis, being transported to hospital when you don’t need to be is traumatising, and can significantly impact how well and how quickly you recover. Taking emergency services out of area for unnecessary transportations to hospital of people in MH crisis, is a drain on time, money and human resources. It also leaves small communities, with limited emergency services in a vulnerable position. By providing Police & Ambulance with the equipment to enable patients to receive a Mental Health Triage in the community via telehealth with a Mental Health Professional, could limit the risk of trauma, the drain on Police & Ambulance resources and ensure people are receiving responsive care. By supporting Police & Ambulance with advice and referral recommendations we build capacity and partnerships in the community. Within the Hunter New England LHD between Jan 2014 & Sept 2015 LHD NSW Ambulance transported 1765 Mental Health Patients to Calvary Mater Hospital. NSW Police were involved in 683 incidents. Many of these Patients were NOT admitted to hospital. Why are we doing this: Improve the patient and carer experience and reduce the risk of trauma Reduce the number of unnecessary transportation to hospital of Mental Health Patients Enable Police and Ambulance to stay in their community for other emergencies Consequences if we don’t: Patients will continue to experience a frustrating and stressful first contact with Emergency and Mental Health Services Unnecessary transportation of Mental Health Patients will continue Emergency services leaving areas at risk due to reduced emergency services Diagnostics Results (CMH – Calvary Mater Hospital, MHP – Mental Health Patient) Police Ambulance Early Access to Mental Health Assessment via Tele-health (PAEAMHATH) Jay Jones Hunter New England Local Health District, David Horseman NSW Ambulance, Tony Townsend NSW Police Force, Liz Newton Hunter New England Local Health District, Beth Gow Hunter New England Local Health District A wide range of diagnostic activities were undertaken as shown below: Sustaining change Succession planning/exit strategy Quality improvement cycle, re-visit staff and patients to gauge acceptance of process Revise checklists Build into process and policy documents of services & Model of Care and Memorandum of Understanding between agencies Engage with key staff within each organisation Ensure Sponsors play an active role to enhance sustainability Include in staff rounding and building cross agency relationships Regular re-fresher/update training PAEAMHATH be a standing agenda item for staff meetings Meetings with Health Economist and Research Officers Integrating the Telehealth technology into other devices currently used by Police and/or Ambulance Contact Jay Jones, Project Co-ordinator [email protected] Method Data analysis meetings Staff & Patient Interviews Diagnostic workshops Literature reviews Process Mapping meetings Solution design workshops Goal To provide the right care, at the right time, in the right place to Mental Health Patients (within scope) by providing alternative care pathways and reducing their unnecessary transport by Police and/or Ambulance to the Calvary Mater Hospital Objectives • To reduce the unnecessary transportation of those Mental Health Patients within scope by 50% to the Calvary Mater Hospital by Police and/or Ambulance • To increase by 100% Police and Ambulance access to a trained Mental Health Professional who will provide recommendations about care to the patient within 12 months of implementation Patient or carer call Triple Zero Police and/or Ambulance arrive and complete checklist to determine if patient eligible for a PAEAMHATH triage. Patient provides consent If NO, patient is transported to hospital If YES Police and/or Ambulance contact the Mental Health Contact Centre via designated telephone number Mental Health professional provides triage to patient via an iPad using tele-health technology Mental Health professional provides recommendations to Police and/or Ambulance Patient needs further assessment and is transported to hospital Patient is deemed safe to stay at home and will be followed up by either Community Mental Health Team or recommended referral New Patient Journey Admitted to Sub- acute Ward, 4 Admitted to Pyschiatric Intensive Care Unit (PICU), 18 Admitted to Adult Acute Inpatient Unit, 33 Admitted: Transferred to another Hospital, 0 Departed: Did Not Wait, 4 Departed: Transfer other Hospital, Not Admit, 2 Not admitted following consultataion, 52 2015/16 Method of Separation for Patients Transported by Police & Ambulance (46% not admitted) 0% 54% 39% 4% 3% Transport of MHP within PAEAMHATH pilot area who did not receive a PAEAMHATH triage, to CMH Admitted to CMH Not Admitted Did not wait Left at own risk Police 84% Ambulance 16% PAEAMHATH TRIAGES INITIATED BY EMERGENCY SERVICES 50% 39% 11% 0% 0% Transport of MHP within pilot area who did receive a PAEAMHATH triage to CMH Total PAEAMHATH triages Safe to stay at home Admitted to CMH Did not wait Left at own risk Not at all comfortable 0% Somewhat comfortable 33% Comfortable 67% HOW COMFORTABLE DID YOU FEEL USING THE TELE-HEALTH EQUIPMENT? (POLICE/AMBULANCE) 0% 20% 20% 20% 40% Were the Police and/or Ambulance satisfield with your recommendations? (MHP) Not at all satisfied Somewhat satisfied Satisfied Very satisfied Extremely satisfied 20% 14% 14% 14% 12% 12% 6% 5% 3% Issues raised from patient interviews pre PAEAMHATH implementation Re-telling history lack of decision making No communication Disempowering Ambo's respectful Not being admitted Police Authoritarian Dislike Police transport Telehealth not for me
Transcript of Police Ambulance Early Access to Mental Health … · Detective Acting Superintendent Wayne...
AcknowledgementsLeanne Johnson General Manager, Mental Health (Sponsor)
Detective Superintendent Chris Craner & Detective Acting Superintendent Wayne HumphreyNSW Police Force (Sponsor)
Chief Superintendent Jeff HescottNSW Ambulance (Sponsor)
Mel Willis/Nicole Manning, Redesign Leads
Emergency staff who participated in interviews/process mapping meetings
Patients/Carers who participated in interviews
Mental Health Contact Centre staff who participated in process mapping meetings
Liz Bosworth, Volunteer Manager,HNELHD MH Services
Samuel Smith, MH Volunteer and Consumer
Front Line Police and Paramedics
ConclusionThe PAEAMHATH project has shown that working in collaboration creates a platform that best meets the needs of patients. PAEAMHATH facilitates a culture of person-centred care that incorporates the needs of families and carers.
The PAEAMHATH project will enhance the ability of Police, Ambulanceand Health Services to deliver Mental Health care throughout Australia,however the project is expected to provide the most benefit in the moreregional, rural and remote areas of the country where patients do nothave access to or choice of Mental Health care.
Case for changeWhen a patient is having a Mental Health (MH) crisis, being transported to hospital when you don’t need to be is traumatising, and can significantly impact how well and how quickly you recover.
Taking emergency services out of area for unnecessary transportations to hospital of people in MH crisis, is a drain on time, money and human resources. It also leaves small communities, with limited emergency services in a vulnerable position.
By providing Police & Ambulance with the equipment to enable patients to receive a Mental Health Triage in the community via telehealth with a Mental Health Professional, could limit the risk of trauma, the drain on Police & Ambulance resources and ensure people are receiving responsive care. By supporting Police & Ambulance with advice and referral recommendations we build capacity and partnerships in the community.
Within the Hunter New England LHD between Jan 2014 & Sept 2015 LHD NSW Ambulance transported 1765 Mental Health Patients to Calvary Mater Hospital. NSW Police were involved in 683 incidents. Many of these Patients were NOT admitted to hospital.
Why are we doing this:Improve the patient and carer experience and reduce the risk of trauma
Reduce the number of unnecessary transportation to hospital of Mental Health Patients
Enable Police and Ambulance to stay in their community for other emergencies
Consequences if we don’t:Patients will continue to experience a frustrating and stressful first contact with Emergency and Mental Health Services
Unnecessary transportation of Mental Health Patients will continue
Emergency services leaving areas at risk due to reduced emergency services
DiagnosticsResults (CMH – Calvary Mater Hospital, MHP – Mental Health Patient)
Police Ambulance Early Access to Mental Health Assessment via Tele-health(PAEAMHATH)
Jay Jones Hunter New England Local Health District, David Horseman NSW Ambulance, Tony Townsend NSW Police Force, Liz Newton Hunter New England Local Health District, Beth Gow Hunter New England Local Health District
A wide range of diagnostic activities were undertaken as shown below:
Sustaining changeSuccession planning/exit strategy
Quality improvement cycle, re-visit staff and patients to gauge acceptance of process
Revise checklists
Build into process and policy documents of services & Model of Care and Memorandum of Understanding between agencies
Engage with key staff within each organisation
Ensure Sponsors play an active role to enhance sustainability
Include in staff rounding and building cross agency relationships
Regular re-fresher/update training
PAEAMHATH be a standing agenda item for staff meetings
Meetings with Health Economist and Research Officers
Integrating the Telehealth technology into other devices currently used by Police and/or Ambulance
ContactJay Jones, Project Co-ordinator
Method
Data analysis meetings
Staff & Patient
Interviews
Diagnostic workshops
Literature reviews
Process Mapping meetings
Solution design
workshops
GoalTo provide the right care, at the right time, in the right place to Mental Health Patients (within scope) by providing alternative care pathways and reducing their unnecessary transport by Police and/or Ambulance to the Calvary Mater Hospital
Objectives• To reduce the unnecessary transportation of those Mental Health Patients within
scope by 50% to the Calvary Mater Hospital by Police and/or Ambulance• To increase by 100% Police and Ambulance access to a trained Mental Health
Professional who will provide recommendations about care to the patient within 12 months of implementation
Patient or carer call
Triple Zero
Police and/or Ambulance arrive
and complete checklist to
determine if patient eligible for a
PAEAMHATH triage. Patient provides
consent
If NO, patient is
transported to hospital
If YES Police and/or Ambulance contact the Mental
Health Contact Centre via designated
telephone numberMental Health professional
provides triage to patient via an iPad using tele-health
technology
Mental Health professional
providesrecommendations
to Police and/or Ambulance
Patient needs further
assessment and is transported to
hospital
Patient is deemedsafe to stay at home and will be followed
up by either Community Mental
Health Team or recommended
referral
New Patient Journey
Admitted to Sub-acute Ward, 4
Admitted to Pyschiatric
Intensive Care Unit (PICU), 18
Admitted to Adult Acute Inpatient
Unit, 33
Admitted: Transferred to
another Hospital, 0
Departed: Did Not Wait, 4
Departed: Transfer other Hospital, Not
Admit, 2
Not admitted following
consultataion, 52
2015/16 Method of Separation for Patients Transported by Police & Ambulance (46% not
admitted)
0%
54%39%
4%3%
Transport of MHP within PAEAMHATH pilot area who did not receive a PAEAMHATH
triage, to CMH
Admitted to CMH Not AdmittedDid not wait Left at own risk
Police84%
Ambulance16%
PAEAMHATH TRIAGES INITIATED BY EMERGENCY SERVICES
50%
39%
11% 0%0%
Transport of MHP within pilot area who did receive a PAEAMHATH triage to CMH
Total PAEAMHATH triages Safe to stay at homeAdmitted to CMH Did not waitLeft at own risk
Not at all comfortable
0%
Somewhat comfortable
33%
Comfortable67%
HOW COMFORTABLE DID YOU FEEL USING THE TELE-HEALTH EQUIPMENT?
(POLICE/AMBULANCE)0%
20%
20%
20%
40%
Were the Police and/or Ambulance satisfield with your recommendations?
(MHP)
Not at all satisfied Somewhat satisfiedSatisfied Very satisfiedExtremely satisfied
20%
14%
14%14%
12%
12%
6%5%3%
Issues raised from patient interviews pre PAEAMHATH implementation
Re-telling history lack of decision making No communication
Disempowering Ambo's respectful Not being admitted
Police Authoritarian Dislike Police transport Telehealth not for me
