Telemed J E Health - Telemental health evaluations enhance access and efficiency in a critical access hospital emergency department.

Tópicos

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Resumo

TRODUCTION: Mentally ill patients in crisis presenting to critical access hospital emergency rooms often face exorbitant wait times to be evaluated by a trained mental health provider. Patients may be discharged from the hospital before receiving an evaluation or boarded in a hospital bed for observation, reducing quality and increasing costs. This study examined the effectiveness of an emergency telemental health evaluation service implemented in a rural hospital emergency room.MATERIALS AND METHODS: Retrospective data collection was implemented to consider patients presenting to the emergency room for 212 days prior to telemedicine interventions and for 184 days after. The study compared measures of time to treatment, length of stay (regardless of inpatient or outpatient status), and door-to-consult time.RESULTS: There were 24 patients seen before telemedicine was implemented and 38 seen using telemedicine. All patients had a mental health evaluation ordered by a physician and completed by a mental health specialist. Significant reductions in all three time measures were observed. Mean and median times to consult were reduced from 16.2 h (standard deviation=13.2 h) and 14.2 h, respectively, to 5.4 h (standard deviation =6.4 h) and 2.6 h. Similar reductions in length of stay and door-to-consult times were observed. By t tests, use of telemedicine was associated with a statistically significant reduction in all three outcome measures.CONCLUSIONS: Telemedicine appears to be an effective intervention for mentally ill patients by providing more timely access to mental health evaluations in rural hospital emergency departments.

Resumo Limpo

troduct mental ill patient crisi present critic access hospit emerg room often face exorbit wait time evalu train mental health provid patient may discharg hospit receiv evalu board hospit bed observ reduc qualiti increas cost studi examin effect emerg telement health evalu servic implement rural hospit emerg roommateri method retrospect data collect implement consid patient present emerg room day prior telemedicin intervent day studi compar measur time treatment length stay regardless inpati outpati status doortoconsult timeresult patient seen telemedicin implement seen use telemedicin patient mental health evalu order physician complet mental health specialist signific reduct three time measur observ mean median time consult reduc h standard deviat h h respect h standard deviat h h similar reduct length stay doortoconsult time observ t test use telemedicin associ statist signific reduct three outcom measuresconclus telemedicin appear effect intervent mental ill patient provid time access mental health evalu rural hospit emerg depart

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