1. Rapid Access to Psychiatric Care Creating a “Safety Net” for High Risk Patients while decreasing Emergency Department Visits and Inpatient Admissions Oakville Trafalgar Memorial Hospital- Halton Healthcare Services NEXT HOME

2. Project Objective & Plan: Objective: Provide patients with rapid access to Mental Health and Concurrent Disorder Services, minimizing patients decompensation, unnecessary ED visits and inpatient admission. Plan: Provide access to Psychiatric care within 7-days Allow access to Concurrent Disorder Services within 2-4 days. Create a Concurrent Disorder Clinician role on inpatient psychiatry. Develop plan within existing budget! BACK NEXT HOME

3. Mental Health Urgent Care Clinic Patients are seen, on average, within 7- days of their ED visit or inpatient discharge and provided up to 3 sessions to bridge them to appropriate services. Outcome: During their involvement with the UCC, out of 346 patients served in year 1, only 3% attended the ED and 4% were admitted. There was a 69% decrease in ED visits when examining the 346 patients 3- months pre and post UCC involvement. From 2008-09 to 2009-10 the program saw a decrease in early repeat ED visits for Mental Health by 1.2% and for Addictions by 1.9%. 2-YEAR ED COMPARATOR 3-mos Pre Post ED Visits BACK NEXT HOME

4. Bridges To Recovery Group Developed an open ended group to allow for rapid access to Concurrent Disorders treatment. The group is intended to (1) bridge clients to more intensive services and / or (2) to enhance current treatment received. Outcome: Significant decrease over a 12-month period for ED visits and inpatient admission during the time patients are engaged in the program. Positive patient satisfaction results as they are now services by one team for Concurrent Disorders. Strongly Agree Agree Undecided Disagree Strongly Disagree BACK NEXT HOME

5. Outcome: Decrease in ED Visits &Inpatient Admissions 64% 15% 33% 37% 51% 92% BACK NEXT HOME

6. Concurrent Disorders Clinician on Inpatient Unit Revamped 1 nursing position to create a Concurrent Disorder (CD) Clinician role to work along the interdisciplinary team on both the adult and child/ adolescent mental health inpatient units. Goal: to engage patient in CD treatment at the time of their admission, considering the high relapse nature of the illness and enhance the opportunities to motivate patients in following treatment. Developed CD Psychoeducational groups, which are delivered twice a week on the inpatient unit with other allied health staff. BACK NEXT HOME

7. Outcome: Positive patient satisfaction results from the 346 patients who have attend groups. A random sample of 21 participants shows a decrease of ED visits by 62% and a decrease of admissions by 86%, 3-month post discharge. 3 Month post discharge for ED Visits / Inpatients Readmits Topic was relevant to patient needs Facilitator was knowledgable Enough time to discuss Information discussed was understandable Patient Satisfaction Survey BACK NEXT HOME

8. Project Participants Bridges to Recovery Group Angela Everest, OT, Jennifer Opper, RN, Tammy Lawless, MSW Concurrent Disorders Clinician  Jennifer Folwer, RN, Erica Howard OTA Shannan Fortier Mental Health Urgent Care Clinic  Dr. Jane Gilbert, Adult Psychiatrist For Further Information, please contact Vivian Demian, Program Director for Mental Health Oakville Trafalgar Memorial Hospital (905) 845-2571 ext 5640 - vdemian@haltonhealthcare.on.ca BACK HOME