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Wednesday, December 6 • 5:45pm - 6:00pm
Implementing Observation Care Pathways for Behavioral Health Patients in NYC Emergency Departments

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Increasing behavioral health patient volume, severity of illness, and decreased inpatient care resources have resulted in extended emergency department (ED) length of stay. Observation care has been a standard within emergency medicine for treating patients with diagnostic uncertainty or those who may benefit from protocol-based interventions to avoid admission. Historically in New York State, Behavioral Health patients have been excluded from observation care within medical Emergency Departments, instead being either rapidly admitted to inpatient Psychiatry or transferred to specialized CPEPs (Comprehensive Psychiatric Emergency Programs).Through close collaboration between Emergency Medicine, Psychiatry, Nursing, Social Work, and hospital leadership, BH Observation pathways were implemented in high-throughput space-constrained Medical Emergency Departments. The aim was to create a standard for short-term treatment, assessment, and re-assessment of behavioral health patients for whom diagnosis and determination concerning inpatient admission, discharge, or transfer was expected to take greater than 8 hours e.g. substance metabolism, dearth of disposition-determining collateral, extended medical workup, etc.In the pilot phase, patients treated without any increase in expense yielded a significant increase in facility and professional revenue, which could be re-invested in architectural and staffing enhancements for BH patients.  An expanded program would have the potential to reduce avoidable brief psychiatry admissions, creating inpatient capacity for higher-acuity ED BH patients throughout the system.

Learning Objectives:
  1. Learn about Emergency Medicine Observation Care, including the benefits and challenges of applying this care model to Behavioral Health patients in Medical Emergency Departments.
  2. Understand first-hand the role of the Emergency Medicine Physician, the Emergency Department Nurse, the Psychiatry Physician, and the Psychiatric Social Worker in Observation Medicine for BH Patients.
  3. Learn how Observation Medicine was implemented for Behavioral Health patients in high-throughput space-constrained medical emergency departments in NYC, including key lessons-learned.

avatar for Jonathan Merson, MD

Jonathan Merson, MD

Medical Director, Behavioral Health Clinical Operations, Northwell Health
Dr. Merson joined Northwell in 2012 as the Division Chief of Emergency Psychiatry at LIJ-CCMC and since 2014 he has held various positions in the Behavioral Health Service Line. He is currently the Medical Director of Clinical Operations, a system-wide portfolio that includes both... Read More →
avatar for Boris Khodorkovsky, MD, FACEP

Boris Khodorkovsky, MD, FACEP

Associate Char, Emergency Department, Northwell - SIUH
Boris Khodorkovsky M.D. is an Associate Chair of the Emergency Department at Staten Island University Hospital. He is board certified Emergency Medicine physician with 20 years of experience in the most challenging and rewarding field of medicine. Throughout his career, Dr. Khodorkovsky... Read More →
avatar for Kate O'Neill, MSN, RN

Kate O'Neill, MSN, RN

Vice President, Northwell Health
Academic Degrees; Bachelor of Science in Nursing, Trinity College, Dublin, IrelandMaster of Science in Nursing/Patient Care Services Administration, Sacred Heart University, Fairfield, CT.BiosketchKate B. O’Neill, MSN, RN is the Vice President for the Northwell Health Integrated... Read More →
avatar for Selma Ali, LMSW

Selma Ali, LMSW

Social Worker, Northwell Health Hospital
Selma Ali began her career by earning a master's degree in Fordham University. Her commitment to helping those in need led her to specialize in psychiatric emergency care. She has previously worked at Mount Sinai Beth Israel CPEP (Comprehensive Psychiatry Emergency Program) and currently... Read More →

Wednesday December 6, 2023 5:45pm - 6:00pm PST
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