TelePsychiatry Improving Outcomes and Metrics at CaroMont Regional Medical Center ED

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CaroMont Regional Medical Center in Gastonia, NC is a major hospital serving a county population of 300,000 and millions more in the Charlotte metropolitan area. When its Emergency Department (ED) was overflowing with psychiatric patients, administrators tapped SOC Telemed to help relieve the burden.

The Challenge

At CaroMont Regional Medical Center, the psychiatric resources of the Emergency Department were stretched thin in 2016. When patients arrived at the ED presenting with psychiatric needs, the hospital was taking too long to process psychiatric consultations – causing long wait times and a strain on resources. The problem at CaroMont is not unique to the hospital; many mental health programs at hospitals across the country in urban, suburban and rural communities alike are understaffed and underprepared for the influx of patients with mental health care needs.

Many patients, if assessed promptly and appropriately, can move out of the ED and into inpatient psychiatric care or return home with outpatient care instructions. However, due to constrained resources, psychiatric care patients often wait three times longer than ED patients, with an average boarding time of 8-34 hours. At CaroMont, the increased volume of mental health patients diverted resources away from other emergency patients, triggering an overflow of more than 1,700 “Code Purple” hours in the ED.

The Solution

CaroMont reached out to SOC Telemed, and in September 2016 the preliminary work began to implement SOC’s Telemed IQ platform to extend provider resources in the CaroMont ED. The neurology department at CaroMont already utilized Telemed IQ for stroke care and quickly integrated psychiatric services into the existing platform.

Today, CaroMont uses the Telemed IQ platform and SOC physicians in cases where the decision to discharge or admit is unclear to the on-site ED physicians, and when an on-staff psychiatrist is not immediately available due to scheduling. This ensures that CaroMont’s psychiatrists are not on call too many nights in the ED, which can accelerate burn out.

With faster, more accurate determinations from on-demand psychiatric experts, patients’ length of stay is reduced. Beds are freed up in a high risk, high volume environment for other emergency services. The results at CaroMont after implementation were immediate.

Like many hospitals across the country, CaroMont’s ED was crowded. Patients with mental health issues faced extended wait times and understaffed psychiatric resources, often leading to needless transfers and fewer beds available for medical emergencies. By launching telePsychiatry with SOC Telemed, CaroMont reduced length of stay for psychiatric patients by 70% in the Emergency Department and increased the medically-appropriate discharge rate to 65%. Improved access and timeliness of psychiatric care in the ED not only had a positive effect on psychiatric patients, it increased bed availability for all patients. As a result, CaroMont reduced its annual Code Purple (overflowing ED) hours from 1,700 to just 148.

The positive impact of SOC’s telePsychiatry program didn’t stop in the ED. Because psychiatry patients received faster consultations, and the quality of care plans for these patients improved, CaroMont improved the mix of patients in its inpatient psychiatric unit. By reducing transfer rates to just nine percent, patients now receive the care they need, closer to home.

“We’ve had a great experience with SOC Telemed and the Telemed IQ platform. Having that abundance of resources out there for us is timely, and our use of SOC Telemed has dramatically reduced wait times and improved cost savings. We can’t say enough about SOC Telemed in our ED.”
Char Biamonte, Ph.D., MA, BS, BC-NE, BC-RN, FACHE,
Nursing Director for CRMC

The Results

Improved Hospital Performance

  • Massive reduction in Psych Code Purple Hours
  • Faster, more efficient and effective care
  • Timeliness and responsiveness
  • Improved performance metrics, staff and patient satisfaction

Better Care For Those In Need

  • Better assessment, shorter wait times
  • Reduction in time to see a psychiatrist
  • Reduced length of stay
  • Increased discharge rates

Improved Census, Better Throughput

  • Less expensive coverage model with standardized clinical protocols, reporting insights
  • Increased throughput means increased capacity for other emergency patients
  • Scalable access to board-certified psychiatrists at any time • Decrease in boarding costs due to a reduction in nursing hours, sitter fees, security costs

SOC Telemed is the first provider of acute clinical telemedicine services to earn The Joint Commission’s Gold Seal of Approval.