Original Research & Contributions Implementation Study

The Banner Psychiatric Center: A Model for Providing Psychiatric Crisis Care to the Community while Easing Behavioral Health Holds in Emergency Departments

Abstract Banner Health in the Phoenix, AZ, metropolitan area provides individuals in a behavioral health crisis with an alternative to presenting to an Emergency Department (ED). By implementing a process to quickly move patients out of our ED, our health care system has been able to greatly reduce the hold time for behavioral health patients. Through access to psychiatric clinicians around the clock at the Banner Psychiatric Center, patients now receive the appropriate treatment and needed care in a timely manner. Finally, disposition of patients into appropriate levels of care has freed up acute care Level 1 beds to be available to patients who meet those criteria.

Introduction Banner Health is one of the largest health care systems in the western US with 23 hospitals and health care facilities in 7 states—Alaska, Arizona, California, Colorado, Nebraska, Nevada, and Wyoming—and more than 30,000 employees. In Arizona, Banner Health has 12 hospitals and 9 Emergency Departments (EDs) in the metropolitan Phoenix area with a combined total of close to 1500 adult patient visits per day. Banner Health is the largest private provider of inpatient mental health services in Arizona. A high percentage of behavioral health patients use the ED to access services in the Phoenix metropolitan area. Even though these patients represent a relatively small percentage of total ED visits, they tend to have a disproportionate impact on ED throughput because they often require additional resources (often 1:1 observation) and have a very long length of stay in the ED.

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