case study

Creating a Crisis Center

A small community was struggling with psychiatric boarding in its local emergency department. A local behavioral health clinic had opened a walk-in clinic to attempt to divert patients from boarding and inpatient admission. However, without an intermediate level of care, the clinic found itself admitting many patients who – with a little more time – could have been stabilized and discharged to the community.

The CXNS Plan

  • Identify patients who could be successfully stabilized with aggressive treatment and overnight observation
  • Assist in the design and development of a 23-hour observation unit
  • Identify and implement key building standards to safely provide an acute level of care
  • Avoid inpatient admissions
  • Avoid boarding psychiatric patients in emergency departments, a practice that is costly and unsafe

Within 6 months:

  • Screening 275 patients per month
  • 85% diversion from inpatient rate
  • Avoided unnecessary inpatient admissions
  • Alternative to emergency departments
  • Drop-off for law enforcement available to serve as an alternative to jail
  • Decreased costly inpatient utilization
  • Decreased costly emergency department boarding


The CXNS Health Strategies team successfully assisted in the design and development of a 23-hour observation unit. This serves as an alternative to the emergency department and jail, with a high rate of diversion from unnecessary inpatient admissions.


Overcoming Barriers to Access

Criminal Justice

Eliminating ED Boarding Through Creation of Center

Alternatives to Long-Term Care

Improving Throughput and Safety in an Emergency Setting

Safety in Crisis

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