[February 11, 2016]

CEP America Launches Nation's First Program to Combine Emergency Medicine and Emergency Psychiatry through Innovative Partnership with Hospitals

With mentally ill patients in crisis often forced to board up to a week in crowded emergency departments (EDs) due to a lack of psychiatric hospital beds, leading to higher costs and poorer outcomes, over-burdened EDs are struggling to find solutions.

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Scott Zeller, M.D. (Photo: Business Wire)

To ensure better care and meet demand, CEP America, one of the nation's largest democratic physician partnerships, has introduced the nation's first Psychiatric Emergency Medicine practice, a comprehensive program that includes Psychiatric Emergency Services (PES), crisis stabilization units and Telepsychiatry.

CEP America's program was developed in cooperation with Scott Zeller, M.D., one of the nation's leading experts in psychiatric emergency medicine. Dr. Zeller is the former medical director for John George Psychiatric Emergency Service, recognized as a leading model for Psychiatric Emergency programs nationwide. For his work in Emergency Psychiatry, he was awarded the 2015 USA 'Doctor of the Year' by the National Council for Behavioral Health and the Holloman Award for Lifetime Achievement in Emergency Psychiatry. Dr. Zeller is past-president of the American Association for Emergency Psychiatry. He joined the CEP America team as Vice President for the Psychiatric Emergency Medicine practice line in February of 2016.

"Too often mentally ill patients end up in EDs with staff that are already over-burdened, and may not have the resources or training to care for them," said Dr. Zeller. "People who are already hearing voices telling them to kill themselves, for example, might find the ED environent to be hectic or frightening, which can interfere with healing - and these patients might end up over-sedated as a result, because staff have few other options. It would be much better for them to get prompt attention from a dedicated psychiatric team to ensure they get the right medications, interventions and care."

Zeller also helps train ED staff to use calming techniques and de-escalation to manage combative and agitated psychiatric patients. He notes that when prompt care is provided through a dedicated psychiatric emergency medicine (PEM) program, there is often less need for restraints or staff used as 'sitters' to simply watch patients, and little reason for excessive sedation. He notes patients can also often have their symptoms managed in a way that enables them to be safely discharged with the support of a program that can connect them with community resources and continued follow-up.

With CEP America's Psychiatric Emergency Medicine practice, patients receive care promptly in an environment that is more calming and conducive to healing than a traditional ED. Patients are evaluated, receive intensive treatment, and are provided time for observation and healing, before discharge home - typically within 24 hours. The goal with each patient is to stabilize acute symptoms and avoid unnecessary psychiatric hospitalization.

CEP America's Psychiatric Emergency Medicine practice provides a model tailored to meet the needs of each individual hospital, as well as aligning with requirements and regulations for county and state programs. Services provided include:

• Regionally Dedicated Psychiatric Emergency Services: Provides 24/7 psychiatric coverage and meets EMTALA guidelines.
• Crisis Stabilization Unit (CSU): Provides timely psychiatric care and is more cost-effective for lower census settings.
• Hybrid Model with Telepsychiatry: Uses telepsychiatry to support either a PES or CSU to augment in-house psychiatric coverage during saturation and/or surge, after hours, and weekends.

The number of patients seeking ED care for psychiatric emergencies continues to rise nationwide, as these patients typically have few other alternatives to relieve their distress. Psychiatric diagnoses account for more than 6.4 million visits to the nation's EDs annually, at a cost to hospitals of more than $38 billion.¹ EDs often must board these patients, who face average boarding times anywhere from 6.8 hours² to 34 hours³ at an average cost to the hospital of $2,264 per patient.⁴

For more information on the psychiatric emergency medicine program from CEP America visit http://www.cepamerica.com/services/emergency-psychiatry or call 800-600-6339.

About CEP America

CEP America, an independent physician-owned partnership, offers a wide range of clinical, staffing and administrative expertise designed to increase clinical quality and service excellence across the acute care continuum. Since its founding in 1975, CEP America has grown to include nearly 3,000 clinicians working in urgent, emergency, inpatient, peri-operative and post-acute care settings across the country. For more information about CEP America, please visit www.cepamerica.com.

¹ Creswell J. ER costs for mentally ill soar, and hospitals seek better way. New York Times, Dec. 25, 2013.

² Weiss AP, Chang G, Rauch SL, et al. Patient and practice-related determinants of emergency department length of stay for patients with psychiatric illness. Ann Emerg Med. 2012;60(2):162-171.e165

³ Tuttle GA. Access to psychiatric beds and impact on emergency medicine. Chicago, IL: Counsel on Medical Service, American Medical Association;2008.

⁴ Nicks B, Manthey D. The impact of psychiatric patient boarding in emergency departments. Emerg Med Int. 2012;2012

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