IU Health Ball Memorial Hospital’s Emergency Department improves behavioral healthcare with safe rooms

Just a few years ago, IU Health Ball Memorial Hospital’s Emergency Department saw two or three behavioral health patients per day. Now, that number has more than doubled.

“The opioid epidemic, increase in alcohol consumption, [those factors] bring patients to have psychiatric problems. They come in in crisis,” says Jenny Harter, an emergency department nurse.

To better care for those patients, IU Health Ball Memorial recently underwent renovations to create a comprehensive, safe environment for behavioral health patients. The new area protects patient privacy, provides increased safety for team members, and offers a better overall patient experience.

What: IU Health Ball Memorial is the first hospital in the IU Health system to have a behavioral health safe environment.
When: Completed late 2018
Why: IU Health Ball’s ED and psych patient volume is exceptionally high. In 2012, 1,560 behavioral health patients had an average length of stay (ALOS) of 9.5 hours. In 2018, nearly 2,800 behavioral health patients had an ALOS of 14 hours. Typical ALOS for medical patients is less than three hours. This investment in behavioral health patients helps ensure they get the highest quality of care. Before the renovation, circumstances were challenging. After the renovation, the care environment is optimal.
How: The healthcare team looked at department flow and the need to improve space and patient/team member experience. Considerations included:

• Team member safety
• Enclosed nurses station
• Ligature-resistant rooms
• Drop-down doors
• Solid ceilings
• Reinforced drywall
• Tempered glass
• 360-degree cameras with robust video monitoring system
• Stryker series behavioral health beds
  • mattresses designed for longer length of stay
• built-in monitoring systems with alarms
• wireless call light systems

Then vs. now: Before the behavioral health safe rooms were complete, the Ball ED had a typical psych patient census of four rooms plus four hall beds; the busiest time of day was noon to midnight. These rooms and beds were located in the main hub of the ED, where there is significant activity and often a noisy environment. An optimal environment for patients is one that is as calm as possible to minimize the need for intervention and de-escalation.

Since the five behavioral health safe rooms have opened—all clustered together and located away from the ED hub—patients and their families have a better overall experience, patient privacy is protected, and team member safety is greatly improved.

Additionally, patient safety companions (similar to patient care assistants), sit close by to help monitor patients, which allows for earlier interventions when necessary. The IU Health Ball Memorial Hospital Police Department has a constant presence in the area as well.

Still to come: By mid-2019, a team member duress system will be implemented for all ED team members, including registration and anyone else who works in the department.

• Panic alarm button on each team member badge
• Alarm will show who pressed the button and their location

Be sure to watch the related video here.

By Dawn Brand Fluhler and Chance Walser

IU Health Ball Memorial Hospital’s Brennan Boland, director of business analysis, and Rebekah Dillon, RN, BSN, MBA, CEN, TCRN, director of Trauma, Emergency Department and Center of Hope, contributed to this article.