By BETSY TAYLOR
On any given day, St. Mary's Medical Center in Grand Junction, Colo., has about six to eight patients in its emergency department who don't have acute medical needs, but need psychiatric treatment. St. Mary's Medical Center is not a psychiatric hospital, and does not have a psychiatric unit.
The medical center has a psychiatric evaluation team, usually working about 30 hours a week during daytime hours; and it has psychiatrists on call, who can evaluate if a patient needs psychiatric care. But on average it takes 12 to 24 hours before the patient can be transferred to West Springs Hospital, a psychiatric hospital in the same community. And if all 32 beds at West Springs Hospital are taken, it could be longer before the patient is transferred to an appropriate care setting for inpatient psychiatric treatment. "Oh, days. It could be multiple days," said St. Mary's Medical Center President Dr. Brian Davidson.
To alleviate mental suffering and get patients psychiatric treatment more quickly, St. Mary's Medical Center is supporting a building project that would double the inpatient capacity of West Springs Hospital. In August, St. Mary's, part of the Broomfield, Colo.-based Catholic nonprofit SCL Health system, said it would contribute $2.5 million to a $35 million project to expand West Springs Hospital.
The 32-bed psychiatric hospital, the only such hospital between Denver and Salt Lake City, is owned by the Colorado nonprofit Mind Springs Health. Mind Springs Health provides mental health services and substance abuse treatment to a 23,000-square-mile area in northwestern Colorado, with offices providing outpatient care in 13 communities along the western slope of the Continental Divide. On its website, Mind Springs says it opened West Springs Hospital in 2005 in reaction to the closing of psychiatric units in Grand Junction, Montrose and Durango, all in Colorado.
The financial donation, which will be made over a few fiscal years, makes good business sense to St. Mary's Medical Center and SCL Health leaders, and fits with a commitment to best serve patients in the region. Davidson said it is meant to advance the concept of right care, in the right place, at the right time. St. Mary's and care providers throughout the region want a health care delivery system in place that will get patients in need of behavioral health prompt, appropriate care.
"We're in a fairly isolated area," Davidson said. Sometimes, "our hospital seems to be the place where you take people when you don't know what to do with them."
It is expensive for St. Mary's to care for psychiatric patients in its emergency room. A patient in an acute psychiatric emergency often requires a "sitter," a staff member who monitors the patient while he or she awaits transfer and treatment. Additionally, the presence of a patient in need of psychiatric care ties up emergency medical beds and clinical staff and "limits our ability to execute our core competencies," Davidson said.
Davidson said there's no guarantee that St. Mary's will save money if West Springs Hospital expands; however, he said it's estimated St. Mary's hospital could save up to $6 million annually if patients with behavioral health needs sought care at West Springs Hospital, rather than St. Mary's. St. Mary's will remain the appropriate venue for psychiatric patients requiring emergency medical care.
Safe, soothing environment
Kim Boe, executive vice president for West Springs Hospital and for a crisis stabilization unit called Transitions at West Springs, said West Springs Hospital appreciates St. Mary's generous contribution.
She said the national average of beds for psychiatric patients is 20 beds per 100,000 people. She said Colorado has about 15 beds per 100,000 people. In the western slope region, where West Springs Hospital is located, there are six beds per 100,000. With the expansion, the hospital still won't have as many beds as even the rest of the state, but with 10 beds per 100,000 people, "it gets us closer," she said.
So far, including the St. Mary's donation, about $7 million has been raised for the West Springs Hospital expansion. West Springs Hospital expects to begin construction once its fundraising campaign reaches $17 million. Construction could start next July, with the project to take about 16 to 18 months, Boe said.
West Springs Hospital currently consists of two adjacent buildings, with 16 beds each.
Boe said one of the existing buildings will come down, and a new building will be constructed on that lot. The other building will remain in use.
The expanded hospital will be a mix of single occupancy and double occupancy rooms. Boe said former patients whose input was sought during the facility planning phase said some people prefer private rooms, while others may feel isolated in a private room and prefer to have a roommate.
Boe said the design incorporates elements to create a safe, calming environment for patients. It includes four courtyards, where patients will be able to engage in therapeutic gardening; an activity room for music and art therapy; and a half-court gym, for play and exercise.
Dr. Leslie Zun, president of the American Association for Emergency Psychiatry and chair of emergency medicine for Sinai Health System in Chicago, speaks nationally about psychiatric treatment, including concerns related to the "boarding" of psychiatric patients, which occurs when patients in hospitals' medical emergency departments are medically stable but waiting for a psychiatric evaluation or disposition.
Zun praised St. Mary's donation to expand West Springs Hospital's capacity. "I think it's a wonderful collaboration. It's really forward thinking to say, 'How can we provide the best care for our patients?'" he said.
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