As behavioral health volumes rise and emergency departments contend with unpredictable medical surges, leaders at WellSpan’s Good Samaritan Hospital in Lebanon, Pa., implemented flexible-use rooms in its emergency department that can convert between medical and behavioral healthcare.
“We’ve seen a 100% increase over the past three years of people seeking behavioral health services,” hospital President Tina Citro, DNP, RN, told Becker’s. “We only have five behavioral health beds that are designated in our emergency room and we’re having to hold people outside of those rooms on a daily basis. … There are more patients than there are safe rooms.”
The rooms were designed to address safety risks, throughput pressures and limited behavioral health capacity while maintaining the flexibility to respond to seasonal demand.
“As some people come into [the emergency department] … we have to do that medical exam. We can bring them into that room, and all the medical supplies are there,” Dr. Citro said. “Then once they’re deemed to be medically stable but they’re still there for behavioral health, [you] can close off those items … and it’s no longer causing a ligature risk for the patient.”
Within seconds, the room can be transformed. Staff with programmed badges can lock two wooden doors that conceal medical equipment and supplies, while reinforced steel doors help prevent unauthorized exits from the area. The hospital now has nine potential behavioral health beds.
During peak respiratory virus season, flex rooms are used more often for medical care than behavioral health.
Every person entering the emergency department requires a medical screening exam. If a patient continues to have behavioral health concerns, the question becomes where to safely place them until they receive care.
“We really need flex rooms because more behavioral health rooms are great,” Dr. Citro said. “But it’s that patient coming in and we’re doing the medical exam, where do we put them? They’re still at risk.”
The hospital took a multidisciplinary team approach to develop the model, engaging behavioral health, clinicians, nursing staff, security and patient safety leaders for feedback. Staff safety was also a top priority.
“When patients have it in their head that they want to leave, they will find a way to leave,” Dr. Citro said. “Often that was at the expense of our staff trying to bring in people from leaving. We certainly don’t want them to get hurt in the process.”
The renovation was funded by a $1 million grant from the Pennsylvania Department of Human Services.
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