Sanford Jackson Medical Center and Community Integrates Behavioral Health

the hospital in Jackson as a rural community is vitally important we have people that are able to come here they don’t have to travel 20 or 30 miles in order to get medical help we have a farming community multi-generational families that live here we have strong community ties we treat our neighbors our family members and our friends prevention and treatment of care is very important to us in the emergency department we were seeing this revolving door with our behavioral health patients they were coming in repeatedly we knew we were sending them to inpatient behavioral health units and the next time we’d see him back is in within a couple of months but we didn’t know what kind of care they received between going to the inpatient Behavioral Health Unit and then coming back to the emergency department so we knew we had some issues that you know we needed to work more with our community partners we knew they were seeing many different agencies but we weren’t getting the communication feedback we needed to really care for our patients we really needed to get these patients back to our primary care provider and do some coordination of care we have worked with the rural health center in the past with other grants and saw this opportunity come available and we had seen a large increase in the number of patients presented to the emergency room with mental health needs and so we felt this would be a great opportunity for us to dig into this deeper find the reasons help these people to keep more keep their appointments stay on their medications all of those things and we knew that it was really important that we start together our community partners not just our staff but also community partners dedicated a full day to discussing what our strengths and weaknesses were what our opportunities for growth related to behavioral health and preventing crisis situations some of our key partners were des Moines Valley Health and Human Services southwestern mental health center another organization is our law enforcement team a key player was an independent clinic here in Jackson we share a lot of patients together having all of those voices in the room and being able to start communication and understand each other’s roles and just work together better it sounds so simple but it was really a key to moving this project forward so after our full-day strategic planning meeting we had broken up into these teams and we planned to report back on the progress that we had made within at least about a month since that time we’ve just really committed to quarterly group meetings and just kind of created this behavioral health task force that continues to meet and discuss the progress that we’re making as we all know it’s difficult to dedicate time time is just our most valuable resource for these types of projects and so engagement felt like it was going to be difficult but we were just really I guess blessed in this community of Jackson that people really saw the need and the importance of continuing to meet around this project and so we’ve been having really good attendance with our task force meetings and actually have had more and more people joining the task force meetings another thing that has helped to keep people engaged is just allowing different people to kind of present information and leave the meetings so it’s not just coming from Sanford standpoint but that everyone is really taking ownership of this task force together we wanted to prevent crisis situations and especially prevent readmissions for similar circumstances we decided on three areas that we really wanted to focus our efforts so the first project was creating a little bit more effort towards our community resource directory what might be missing from that directory and how can we better let our community know that it exists and that and how to distribute it the second team was around crisis planning and communication our third team was creating a release of information form that could be shared with all of the community and partner organizations that we were working with so many of us in the community are working with the same clients the same patients we really want to be able to talk to each other when it’s appropriate about what’s the plan how can we help this person and so we really kind of were dreaming about this shared release of information form that would allow us to do that more efficiently when you have a person in crisis that is probably one of the last things they want to do is sign a piece of paper for you unless you can get them to a point where they’re understanding why you need it and what you need it for and so we we developed this great form where was one signature from our patients one check mark this is what we need to continue care I think next steps it’s something that we have in mind is involving our schools and the children just through request from the schools once they found out we were doing this project it was like can we be in on this – we really took the opportunities then to start collecting some data about what’s going on in our facility and that really helped drive us forward some of our biggest outcomes was really being able to see the number of those behavioral health patients decreasing but also the percentage of those patients who were discharged to an inpatient behavioral health facility decreased significantly from 47% to 23% in a one year period things that we’ve implemented that have made the biggest difference have been just very simply increased communication we know what each other can do so that increased communication although it simple has been vital part of this project really what we found is that the smallest change made the largest impact for our patients it doesn’t have to be the big things it’s it’s the communicating it’s the teamwork it’s learning each other’s processes and understanding those processes that made the biggest impact we know that behavioral health is a need and we know that there’s room for improvement so it’s important to go ahead and get started and start the discussions on what it looks like to take small steps or to dream big about what we can do better I feel it is our obligation to be the leader in this process with behavioral health people do look towards us for answers and in a small community there’s not a lot of resources especially on nights and weekends and so when people come to us we need to be able to provide those resources to our patients

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