Monday, July 16, 2012
Peninsula prepares for community-based mental health services with capital improvements and more staff
Since last fall when Doug Varney, the state’s commissioner of mental health, announced the state’s intent to close Lakeshore Mental Health Institute this June, the staff of Peninsula has been busy preparing for the influx of patients it expects in the wake of the closure.
While two other psychiatric facilities – Woodridge in Johnson City and Ridgeview in Oak Ridge – will take on some Lakeshore patients, most will go to Peninsula, an acute care psychiatric hospital in Louisville and a division of Parkwest Medical Center.
The state’s plan for closure of Lakeshore is a step toward community-based treatment, a concept that helps those with mental illness to remain citizens of their community by offering support and access to mainstream resources such as housing and vocational opportunities.
“Most states across the nation have moved – or are in the process of moving – away from state-run institutions to community-based mental health services,” said Peninsula Vice President Jeff Dice. “We know funding is a problem, and Peninsula is trying to help the state with a solution.”
Peninsula completed a six-month trial run requested by the state during which Peninsula took uninsured patients of certain acuity levels who would have typically gone to Lakeshore. Lakeshore stopped taking acute patients on June 1.
“For the most part it has been smooth,” said Liz Clary, Peninsula Hospital administrator and director of patient care services. “The bumps that we have experienced are the ones we anticipated, and we’re working to correct those.”
One such “bump” is volume. Roslyn Robinson, a registered nurse at Peninsula, said that the facility would typically average about 20 admissions per weekend. But during the trial run, that has leapt to close to 50. The typical average daily census of 60-70 patients has grown to between 80 and 100 and is still growing. There were days in March when census jumped to more than 100 patients.
Clary explained how psychiatric facilities place patients in beds is quite different from how medical acute care hospitals work.
“For example, although Peninsula Hospital is licensed as a 155-bed facility, patients within the facility must be the correct gender, age and acuity level for a particular unit. It is improbable that the “mix” would be right to house even 115 patients,” she said.
Another “bump” is payment, although the state has a grant to cover the uninsured patients Peninsula is taking during the trial.
In addition, Peninsula’s leadership is looking at staffing levels to assure safety and service for the patients.
“We have filled 25 new positions and have other positions in the approval stage,” said Dice, adding that Dr. Bert Simpson, former medical director of Lakeshore, has joined Peninsula.
“Peninsula Hospital has initially invested approximately $300,000 in capital improvements,” Clary added. “This includes the remodeling of the current admissions/switchboard area, combining the two to enhance efficiencies in the admissions and discharge process and a renovation of the walk-in assessment room to include the Telemedicine (remote assessment) function.”
“Down the road, we will expand our Hope and Recovery rooms to allow for an additional large space to use for programming and as a better common/day area space and will be expanding the current day area on Unit B,” Clary said. “For our patients, this means enhanced programming and better spaces to relax and receive services outside of their rooms,” Clary explained.
Adjustments will also be made to accommodate more psycho-educational groups and individual therapy sessions. “We anticipate these changes will make the experience better for our patients and their families,” she said.
Dice said that while Peninsula will do all it can to accommodate patients diverted from Lakeshore, situations may arise where patients may be sent to other state-run mental health facilities in Middle or West Tennessee either because of space limitations or because they are clinically inappropriate for the services offered by Peninsula.
Did you know?
Peninsula Hospital is for short-term patients, with the average length of stay being fewer than six days.
Patients usually are appropriate for Peninsula Hospital when the following care services are needed:
1) around-the-clock intensive, psychiatric/medical, and nursing care including continuous observation and monitoring
2) acute treatments to control behavior and symptoms requiring stabilization,
3) acute management to prevent harm or significant deterioration of functioning and to ensure the safety of the individual and/or others,
4) daily monitoring of psychiatric medication effects and side effects, and
5) a contained environment for specific treatments that could not be safely done in a nonmonitored setting.
Peninsula Hospital provides inpatient mental health and alcohol/drug crisis stabilization services for adults, adolescents and children.
Peninsula Hospital also offers medical detoxification for chemically dependent patients and is one of the few facilities in the area that can accept involuntary commitments.