Returning Safety, Dignity to Behavioral Health
CHALLENGE
The closure of a nearby state facility required preparation for an influx of high-acuity behavioral health patients. At the same time the existing model of care failed to deliver the promise of a therapeutic milieu for patients or a safe environment for staff. Movement of behavioral health patients from the ED to the inpatient behavioral health unit required travel through interventional cardiology, up visitor elevators, through the main lobby and past the cafeteria with its wall of windows into the corridor. Staff were concerned for their personal safety while patients sought better options to preserve their dignity and privacy.
30+ stakeholder interviews
Baseline strategy validation
Operational analysis
Time-motion studies
Clinical functionality assessment
Patient consumer experiential analysis
Provider consumer experiential analysis
Co-creation sessions to explore new models of behavioral health care
Customized demand projections
Key room forecast
Space programming
Concept development
Clinical design peer review
APPROACH
Careful analysis of projected volumes and current challenges identified the need for an entirely new model of care, and a facility solution that relocated acute assessment and stabilization of behavioral health patients to a better location on the campus. Employing design thinking, lean, and service design strategies, the future condition was co-created with facility staff with a focus on developing a solution that responded to specific success and value expectations while elevating the patient experience.
RESULTS
The project exceeded the client’s expectations in countless ways.
After exploring multiple models of care, the health system elected to build and operate a behavioral health emergency department / crisis stabilization unit immediate adjacent to a new medical emergency department. The medical emergency department was designed with four behavioral health safe rooms in the main department circulation. Patients requiring medical stabilization could be safely cared for in these rooms with direct line-of-sight monitoring from a nursing station. When not caring for behavioral health patients, the rooms can be quickly converted to care for medical patients.
Within the behavioral health emergency department / crisis stabilization unit, a “living room” concept was employed. The living room is a communal space design to de-escalate and provide freedom of movement for appropriate patients awaiting evaluation and disposition. Four private patient rooms were also designed within the unit for higher acuity patients and those preferring privacy.
A hallmark of the unit design and positioning on the campus was the ability to safely and conveniently provide medical screening within the confines of the behavioral health emergency department / crisis stabilization unit.
0
physical restraint use during first 6 months of operation
0
staff injuries from patient violence during first 6 months of operation