Provincial Health Services Authority Link: Connecting Patients
and Families with Mental Health Resources Shawna Wilwand (BCMHSUS)
Kristen Barnes (PHSA imPROVE)
Slide 2
Provincial Health Services Authority BC Mental Health and
Substance Use Services Provincial specialized services for
children, youth and their families Inpatient units Outpatient
clinics Supported by PHSA imPROVE to implement lean thinking and
tools One tool used is the Rapid Process Improvement Workshop
(RPIW)
Slide 3
Provincial Health Services Authority Context: BC Childrens
Hospital Emergency Department Mental Health patients approximately
900 visits a year 66% are discharged directly from Emergency Where
the patient is referred upon discharge depends on a number of
factors and is a complex process
Slide 4
Provincial Health Services Authority Current State Emergency
Physician Feedback
Slide 5
Provincial Health Services Authority Problem 40% of families
with mental health concerns discharged from BC Childrens Hospital
Emergency did not receive services in a timely manner after
discharge.
Slide 6
Provincial Health Services Authority Contributing Factors 25%
of referrals did not go to the right service Quality of referrals
Access to community services Inequity in Service: Psychiatric
Liaison Nurse position only available to patients during working
hours-37.5 hours/week. Only 15% of patients presenting with mental
health concerns received follow up.
Slide 7
Provincial Health Services Authority Intervention-BCCH
Emergency Department Created one standardized crisis referral form
(down from 11) Created an information handout for patients and
families to access community supports Psychiatry and Emergency
Physicians collaborated on a standardized assessment tool Created
an algorithm for disposition in Emergency
Slide 8
Provincial Health Services Authority Measurement: ED Outcomes
99% of families directed to the correct service (compared to 75%
before interventions) Equity in Service: All patients with mental
health concerns presenting to the emergency department who require
follow up receive follow up
Slide 9
Provincial Health Services Authority Intervention-BCMHSUS Link
New service to help connect families with community mental health
resources. Provides mental health assessment, medication initiation
and management, and resource consultation. Link can provide a
maximum of 4 follow up sessions. Without adding new resources, Link
is expected to provide services to an estimated 300 families in its
first year
Slide 10
Provincial Health Services Authority Who is LINK? Link is a
team of Mental Health professionals including: Nurse Clinician-
Shawna Wilwand Nurse Practitioner- Ardelle Komaryk Social Worker-
Karen Cooper Psychiatrist- Dr. Jennifer Russel
Slide 11
Provincial Health Services Authority Measurement: Services
Provided by Link Received 108 referrals accepted 91% others already
connected and the patients care provider notified. Since August 15
th, 2014 Link has provided services for 98 families Contact
patient/family within 2 business days 99% of the time Services
provided 88% connected with nurse clinician 13% connected with
social worker 5% connected with nurse practitioner 11 patients
(11%) urgent non-emergent psychiatric assessment
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Provincial Health Services Authority Measurement: Patient
Experience Feedback from families and the community has been
overwhelmingly positive. When asked about their experience with
Links over the phone services: Patients and families said:
Community partners said: We felt safe, helped and supported Link is
a great program, I am thankful for the follow-up call Helpful, glad
someone followed up Always goodto communicate with community and
all partners clients often present in the emergency department and
we are not aware Thank you for everything you did getting us
support. Son is doing better now and what you did really made a
difference Amazing you helped my child so much
Slide 13
Provincial Health Services Authority Patient Experience Survey
(n=5) 100% of patients/families responded definitely when asked if
Link had helped 100% strongly agreed/agreed: Told about resources
Understood purpose of service Knew who to contact Comfortable
asking questions Given answers I could understand Felt
respected
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Provincial Health Services Authority Key Messages Without
increased cost and assigning new resources, we created a service
that has increased the quality of patient care and follow up for
mental health presentations to the emergency This process involved
working across organizations, regions, and sectors of care. To
overcome this challenge, members of the BC Childrens Hospital
Emergency Department, BC Mental Health, community partners and
families worked collaboratively to design the new process.
Slide 15
Provincial Health Services Authority Contact Information Shawna
Wilwand Link Nurse Clinician Email:[email protected] Phone:
604-875-2345 Ext 4948 Kristen Barnes imPROVE Facilitator Email:
[email protected] Phone: 604-813-7682
