Development of a Prioritization Model to Compare Emergency Psychiatric Coverage Service Options

Abstract

Background: Reducing Length of Stay (LOS) is an important way for hospitals to improve emergency department (ED) costs and outcomes. Psychiatric patients represent a challenge to reducing LOS when the scarcity of psychiatric specialists leads to longer LOS. Previous literature describes the unique solutions different hospitals have employed across the US, but does not share methods for evaluating or selecting a solution that can be applied to other hospitals.Methods: We conducted a review of hospital ED case data, market research on psychiatry services, and interviews with hospital staff. This information, along with projected return on investment, was aggregated to create a holistic model for evaluating different service options and selecting the one with the best fit.Results: To develop a prioritization model that identifies the one psychiatric service improving psychiatric LOS and best fitting the hospital’s overall priorities and operations, our methodology identified 8 key factors that captured the overall difficulty of implementation and benefits associated with each service option.Conclusion: The Prioritization Model created in this study was instrumental in selecting the solution for reducing LOS in a way that best meets patients’ and the hospitals’ needs. This model may be applied to other hospitals and service evaluations to provide a holistic review and direct comparison of opportunities.