Transcript St. Croix County Presentation

Washburn County HHSD/Northwest Connections
Shell Lake, Wisconsin
Change Team Members: Jim LeDuc, Iris Ostenson,
Telephone/Mobile Crisis Teams
AIMs
 Big Aim: Reduce re-hospitalization
 Little Aim: Identify and reduce the inappropriate use of Chapter 51.15(ED)
hospitalizations for crisis situations where alcohol is a primary issue. By reducing these
hospitalizations we will be reducing hospitalization in general, which contributes to the
big AIM.
 Reviewed data over the last three years and identified many of the ED cases also had
AOD concerns on board
 Conducted case by case review for the first three quarters of 2012
 We wanted to identify “was alcohol prevalent and the leading issue in the
majority of these cases.?”
 We began reviewing each case that resulted in an ED that had alcohol on board
for appropriateness and those that had alcohol on board that did not result in an
ED –what was done differently?
 What we identified is that if we could hold the assessment process until the
person was no longer incapacitated by AOD, we would be better able to assess for
acute inpatient care needs
Change Plan
 Increase assessment content to better explore primary issue at time of




contact(MH, alcohol, drug, etc)
Delay the detention and admission process with individuals who’s
primary issue at the time of contact is alcohol/drug intoxication
Increase communication with local emergency room departments to
accept individuals with alcohol/drug intoxication until they are able to
be assessed
Increase communication with local law enforcement to take individuals
with alcohol/drug intoxication for medical attention until they are able
to be assessed
Any time that a situation appears to be an ED no community safety
plan can be developed, mobile will be sent vs. an over the phone
approval
Change Project Data
Project Data
Quarter 1
Quarter 2
Quarter 3
Number of Crisis Calls
49
42
48
Number of Emergency Detentions
17
8
7
Number of Detentions with Alcohol or
Drugs as identified as a primary factor
9
4
1
Quarter 1:
•Reviewed data from
previous 3 years
•Identified small Aim
•Case by case review
•Trained staff in new
assessment tool
Quarter 2:
•Implemented new
assessment tool
•Case Review
•LE/Hospital
Discussions
Quarter 3:
•Case Review
•Increase staff guidelines
/protocols to match
change plans
Adopt, Adapt, Abandon
 All change methods were adopted
 The ongoing relationship with hospitals and law
enforcement was key in implementation of three of
the four changes that were made
 The new assessment tool not only increased screening
for situations with AOD on board but also increased
screening for risk and protective factors thus showing
the decrease in emergency detentions overall
Impact and Plan
 Impact
 Reduced the number of individuals civil liberties being taken
away by placing them on an emergency detention
 Reduced the number of trips to acute inpatient care facilities
 Reduce the cost to county systems with un-necessary
emergency detentions
 Increases validity of assessment process
 Plan
 On-going collaboration with this team to maintain best
practice assessment standards and communication
 Share this project data and outcome with other counties in
this region for possible adaptation