Emergency Department: Effectiveness of a Referral Intervention for High Utilizers

This research examined the impact of a referral intervention for patients with high utilization of the Emergency Department (ED) for non-­‐emergent care. The referral intervention was offered by the ED provider who provided the patient with feedback regarding their utilization along with a referral to outpatient services including: primary care physicians, mental health services, and brochure of available resources in the local area. This study used archival retrospective data, and compared frequency of ED visits pre-­‐ intervention and referral to post-­‐intervention frequency of visits and length of time between intervention and next visit. Following the intervention, the participants were classified as either responders or non-­‐responders based on their recidivism. An independent sample t-­‐test showed that the responder group had a significant decrease in number of visits to the ED during the post-­‐intervention period. Additionally, the responders had a significantly longer lag time before they returned to the ED as compared to the non-­‐responders. The referral did not significantly increase patients’ visits to their primary care physician/behavioral health consultant. Therefore brief-­‐ED based intervention may be useful in reducing recidivism in the ED

Identifying Risk Factors for Youth Hospitalization in Crisis Settings: A Classification and Regression Tree Analysis

Traditionally, treatment option for psychiatric crises was limited to psychiatric hospitalization. However, psychiatric hospitals are expensive and little evidence supports their utility. Youth returning from psychiatric hospitalizations often have difficulties readjusting to everyday life which can increase risk for negative outcomes. Alternative treatment options such as mobile crisis services might be useful for stabilizing youth in the community and garnering better long-term outcomes. For alternative treatment options to work, clinicians must be able to efficiently and accurately distinguish youth in need of psychiatric hospitalization and youth who could be served via an alternative service. Therefore, the purpose of the present study is to examine the predictive utility of risk factors available at the time of the hospitalization decision and develop a decision tree that clinicians could use to aid in the decision-making process. Data consisted of 2,605 youth aged 4.0 – 19.5 years (M = 14.07, SD = 2.73, 56% female) who utilized the Mobile Crisis Response Team in the State of Nevada between 2014 and 2017. Using Random Forest, the 13 most important risk factors were identified. Classification and Regression Tree provided an interpretable, easy to use decision tree (accuracy = .88, AUC = .82). In summary, the most important risk factors for hospitalization reflected current functioning. Lifetime risk factors (e.g., diagnosis) were not strong predictors of acute decision-making when acute risk factors were available. Clinicians should attend to current symptoms (e.g., suicide behaviors, danger to others, poor judgment, psychotic symptoms) and environmental factors (e.g., poor functioning at home, poor caregiver supervision) that increase a youth’s risk for harming oneself or others when deciding whether to hospitalize or stabilize a youth in psychiatric crisis

Social, administrative and educational dimensions of the “human – subject of economic life” phenomenon under conditions of information society transition to a new level of development

Перехід інформаційного суспільства на новий рівень розвитку в тріаді генезисних процесів «становлення – формування – розвиток» спричинює численні зміни. Серед них: становлення суспільства знань; інтенсивний розвиток інформаційного простору задіянням ресурсів активного інформаційного простору, неактивного інформаційного простору майбутнього та неактивного інформаційного простору минулого; становлення рольового призначення людини як трудового потенціалу і людського капіталу. Ці зміни актуалізують процеси формування та розвитку людини-суб’єкта економічного життя. Розгляд цих процесів у суспільному, управлінському та освітньому вимірах дає можливість виокремити низку домінант сучасності. Це зростаючо-домінуюча роль комп’ютерної комунікації. Спрямування управління на поєднання інтересів окремих людей з інтересами організації та її стратегічними цілями. Задіяння соціального управління як менеджменту людських ресурсів. Розвиток людини як особистості. Формування та розвиток ІК-компетентності в системі неперервної освіти.Переход информационного общества на новый уровень развития в триаде генезисних процессов «становление – формирование – развитие» вызывает многочисленные изменения. Среди них: становление общества знаний; интенсивное развитие информационного пространства задействованием ресурсов активного информационного пространства, неактивного информационного пространства будущего и неактивного информационного пространства прошлого; становления ролевого назначения человека как трудового потенциала и человеческого капитала. Эти изменения актуализируют процессы формирования и развития человека-субъекта экономической жизни. Рассмотрение этих процессов в общественной, управленческом и образовательном измерениях дает возможность выделить ряд доминант современности. Это растущая и доминирующая роль компьютерной коммуникации. Направление управления на сосотнесение интересов отдельных людей с интересами организации и ее стратегическими целями. Задействования социального управления как менеджмента человеческих ресурсов. Развитие человека как личности. Формирование и развитие ИК-компетентности в системе непрерывного образования.The information society transition to a new level of development in the triad of genesis processes of "incipience – formation – development" causes a lot of changes: the formation of a knowledge society; intensive development of the information space by using the resources of the active information space, the inactive information space of the future and the inactive information space of the past; formation of person’s purpose as labor potential and human capital. These changes actualize the processes of formation and development of the human as subject of economic life. Consideration of these processes in the social, administrative and educational dimensions makes it possible to single out a number of dominant features of the present – it is the growing dominant role of computer communication; management focusing on combining the interests of individuals with the interests of the organization and its strategic goals is important; engaging social management as human resource management; personal development of human; formation and development of IСT competence in the system of continuous education

Focal Spot, Winter 2007/2008

https://digitalcommons.wustl.edu/focal_spot_archives/1107/thumbnail.jp

Behavioral Health Crisis Intervention for Emergency Department Patients Pending Psychiatric Hospitalization

Emergency departments (EDs) are often the first access point to services for suicidal patients (Miller et al., 2017) and assessment of risk. Suicide has become the second-most common cause of death for Americans, yet those at the most risk often have limited access to appropriate care. In addition, suicidal patients spend more time in the ED than those with other presenting problems. Compounding the problem is these patients who have the longest length of stay are medically stabilized but don’t receive treatment interventions related to their presenting problem. Together, these findings indicate a need for accessible intervention in the ED. This study is a program development of an intervention protocol and training designed to initiate treatment for behavioral health problems in the ED. The program’s goal is to provide services for individuals still actively suicidal or at high-risk but waiting in the ED for psychiatric hospitalization. Training outcome results indicate an overall significant improvement in trainee competency and comfort in administering the intervention protocol, as well as a large effect size, indicating more robust generalizability in other settings. However, analysis indicates some discrepancies in competency areas, warranting future training improvements. Results, limitations, and considerations for future research are also discussed

Transactions of 2019 International Conference on Health Information Technology Advancement Vol. 4 No. 1

The Fourth International Conference on Health Information Technology Advancement Kalamazoo, Michigan, October 31 - Nov. 1, 2019. Conference Co-Chairs Bernard T. Han and Muhammad Razi, Department of Business Information Systems, Haworth College of Business, Western Michigan University Kalamazoo, MI 49008 Transaction Editor Dr. Huei Lee, Professor, Department of Computer Information Systems, Eastern Michigan University Ypsilanti, MI 48197 Volume 4, No. 1 Hosted by The Center for Health Information Technology Advancement, WM