November 18, 2008

Implementing the Medical Clearance Checklist for the Assessment and Transfer of a Patient with Mental Illness to a State-Operated Hospital

IHA and MCHC on November 13 co-hosted a Webinar about medical clearance criteria and protocols that recently were implemented on June 1, 2008 by state operated hospitals (SOH) and private hospital emergency departments (ED). The development and implementation of the criteria are the result of collaboration by a cross section of providers and advocates to improve the assessment of a patient with mental illness who presents in a hospital emergency department and is determined to be appropriate for transfer and admission to a SOH. A large and growing number of persons with mental illness seek care for psychiatric conditions in Illinois EDs. For those patients who require inpatient admission, the ED wait times are very long, especially when the patient likely will be transferred to a SOH. Standardizing assessment criteria and protocols was viewed by ED and SOH physicians alike as one mechanism through which to reduce these wait times and ultimately to contribute to a more patient-centered experience.

Dr. Jerry Leikin, an emergency department physician and toxicologist from Northshore University Health System, presented information about how the criteria were originally developed and recently revised by the IHA-DMH Patient Assessment and Transfer to SOH Task Force. Dr. Leikin also provided the clinical rationale behind the criteria and supporting evidence for them. Dr. Dennis Beedle, Deputy Director, Clinical Inpatient Services, Division of Mental Health, discussed those medical conditions that cannot be appropriately treated in a SOH. He expressed his desire to work collaboratively to ensure each part of the mental health system works well and that it not duplicate itself. Moreover, that the work proceed in a non-judgmental fashion within a framework of improving the quality of care.

Background materials about the development of the medical clearance criteria and the Medical Clearance Checklist and Medical Contraindications form are available by clicking here.