1. Unity PES Care Model
Session 2, November 20, 2015

2. Agenda Introductions Define Desired Outcomes
Scope of Living Room vs. PES Milieu
Patient Profile Breakout
ED Data Review
Review big buckets
Activity: Fill the buckets with subtasks
Define Next Steps
Pressures/ priorities
Required resource

3. Brainstorming Activity
Break into small groups
Brainstorm a list of responses to the question: What do we want to achieve with a patient by the time they are leaving the unit?
Identify a recorder and a reporter
Each group to report back to the group in 30 minutes

4. Six goals of emergency psychiatric care (Zeller, 2010)
Exclude medical etiologies and ensure medical stability
Rapidly stabilize the acute crisis
Avoid coercion
Treat in the least restrictive setting
Form a therapeutic alliance
Formulate an appropriate disposition and transition of care plan

5. ED Average LOS non-Admitted
ED Patients Not Admitted
Legacy
Adventist
OHSU
Total
ED stay < 3 hours
2,742
2,901
441
6,084
Total ED visits
8,180
5,547
1,902
15,629
% under 3 hours
33.5%
52.3%
23.2%
38.9%

6. ED Patients non-Admitted (n 5617, Legacy, Adventist, OHSU)

7. ED non-Admitted LOS beyond 24 hours (n 15,629 Legacy, Adventist, OHSU)

8. Top Dx for ED non-Admitted LOS >24 Hours (n 1210 Legacy, Adventist, OHSU)

9. The “Big Buckets” of the Care Model Work plan
Define desired outcomes UM
Intake/admissions
Peer Support
Direct Patient Care
Access
Care Management - D/C Planning
Safety & Security
Treatment Team
Formal Governance
Programming
Pharmacy
Shared Governance
Policy & Procedure
MD Psych Eval/ Medical Model
Family

10. Brainstorming Activity
Break into small groups
Brainstorm what needs to be considered/answered/designed as subtasks in each category.
Identify a recorder and a reporter
Each group to report back to the group in 25 minutes

11. Scope Definition: Living Room vs. Milieu

12. Patient Criteria for Living Room and PES Milieu
Share patient scenarios

13. Next Steps

14. Thank you!