Admittance procedures for West Springs Hospital
Given that it serves a wide array of patients suffering from a wide array — and degree — of mental-health issues, West Springs psychiatric hospital adheres to a stringent and institutionalized set of admittance procedures. Here we ask Executive Vice President Kim Boe to answer a few admittance-related questions.
RFWJ: If a person is in the Pitkin County Jail for, say, disorderly conduct or resisting arrest and, in the mind of the jail staff, is displaying clear indications of mental illness, you would consider admitting that person so long as you were confident he/she did not put your facility/patients at risk?
Boe: We would consider admitting, provided we are able to determine that the resisting arrest behaviors or disorderly conduct behaviors would not put our other patients at risk or disrupt the milieu. We also would need an understanding of disposition upon completion of hospitalization –—back to jail, or …
RFWJ: Could you go through your admittance protocol? How you determine if you are going to admit someone and what happens once you have decided to admit someone?
Boe: We receive a referral from an agency, which includes jails. We gather the clinical information from them that should support a psychiatric hospital admission. We present that clinical information to the psychiatric provider at WSH who makes the decision that the clinical information indicates hospital admission is appropriate, or determines the information does NOT support hospitalization. If it is clear hospital admission is appropriate, the admission team alerts the referral source that the individual referred is “accepted” for admission and transportation is discussed and determined. The admission team also alerts the referral source if a referred individual is determined NOT to require hospitalization. We make sure we have a bed.
RFWJ: Does any of the admittance process occur before a potential patient is brought to the facility?
Boe: The coordination with the referral source takes place prior to the patient being brought to the facility.
RFWJ: Once you have decided to admit someone, what’s the orientation process (or whatever you call it)?
Boe: Upon arrival, the remaining admission work is completed — mostly paperwork. The individual’s belongings are inventoried and stored for them. The patient is escorted to the adult unit or adolescent/child unit, introduced to staff and the other patients and oriented to the unit activities, what to expect, etc.
RFWJ: How do you decide when it’s time to release a patient?
Boe: The team working directly with the patient meets daily to discuss patient progress toward discharge. The decision to discharge the patient is made by the team, but ultimately by their treating psychiatric provider, either psychiatrist or psychiatric nurse practitioner.
RFWJ: Where do released patients typically go and what typically happens after that? (Follow-up of some sort?)
Boe: All patients leave with an aftercare plan in place to include follow-up appointments with the appropriate care providers. Dates, times and addresses of those providers are included on their aftercare plan. Discharging patients go to their home, family members, friends, back to their placement, etc.…
RFWJ: Most of your patients are there mandatorily, correct?
Boe: The majority of our patients come to us on an involuntary, 72-hour commitment, but we do have patients who come to us voluntarily.
RFWJ: You have had incidents with patients, yes? What happens if a patient, say, acts out violently?
Boe: Our facility has space set aside to help us deal with patients who act out violently. Additionally, our provider team can offer and provide medication to assist violent patients