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Background: Lean has been increasingly applied in health care to reduce waste and improve quality, particularly in fast-paced and high-acuity clinical settings such as emergency departments. In addition, Lean’s focus on engagement of frontline staff in problem solving can be a catalyst for organizational change. In this study, ConnectionsAZ demonstrates how they applied Lean principles […]

ABSTRACT While Crisis Intervention Team (CIT) programs provide law enforcement with tools to respond to mental health crisis, they are focused on the emergency response. The Tucson Mental Health Support Team (MHST) model was developed following a mass casualty event in order to prevent crises and associated threats to public safety via earlier intervention. Through […]

Abstract Banner Health in the Phoenix, AZ, metropolitan area provides individuals in a behavioral health crisis with an alternative to presenting to an Emergency Department (ED). By implementing a process to quickly move patients out of our ED, our health care system has been able to greatly reduce the hold time for behavioral health patients. […]

Those accountable for a system of care have an interest in managing services to maximize the potential for wellness in community settings. Promoting care in the least-restrictive environment possible is more recovery oriented than providing avoidable inpatient care, and it has been enshrined into law by the U.S. Supreme Court’s Olmstead decision. Community-based care is […]

TO THE EDITOR: The November Taking Issue column by Marvin S. Swartz (1) tackles the complex problem of emergency department (ED) boarding and its relationship to inpatient psychiatric bed capacity. As an organization specializing in facility-based crisis services, we are glad to see this issue receive attention and have the following comments: Although the Smith […]

Effective collaboration between law enforcement and crisis systems can improve outcomes for people with mental illness and for public safety. For example, theMemphisModel of crisis intervention training (CIT) enhances police officers’ skills for safely deescalating crises. However, such programs focus on emergency response. After the 2011 shooting of U.S. Representative Gabrielle Giffords, the Tucson law […]

Abstract Crisis and emergency psychiatric services are an integral part of the healthcare system, yet there are no standardized measures for programs providing these services. We developed the Crisis Reliability Indicators Supporting Emergency Services (CRISES) framework to create measures that inform internal performance improvement initiatives and allow comparison across programs. The framework consists of two […]