Emergency rooms are designed to assess and treat patients with medical emergencies. They are not meant to serve as long-term behavioral health treatment settings, yet some patients with mental health needs may wait hours or days before the appropriate placement can be found.

According to MaineHealth data, the average length of stay in an emergency department (ED) for someone with a behavioral health condition is much longer than that of a patient with a physical medical condition.

“Time is of the essence for treating patients with behavioral health challenges. The sooner we can get that person into the right setting, the sooner treatment and recovery can begin. While the emergency department is the right place for those in crisis, it is not meant to provide sustained psychiatric care. De-escalation can quickly turn to re-escalation if the environment is over stimulating,” said Gina DiDonato, Associate Chief Nursing Officer at MaineHealth Behavioral Health at Spring Harbor (MHBHSH).

Delayed admission to inpatient behavioral health services combined with a lack of available beds is a problem. To address this issue, MHBH piloted Inpatient Behavioral Health OneCall (IP BH OneCall), a centralized inpatient behavioral health bed management system, with two of its Southern Maine hospitals this year.

As the name suggests, one call connects referring parties with OneCall Transfer Center Specialists who facilitate admission to inpatient services at MaineHealth Behavioral Health at Spring Harbor and MaineHealth Maine Medical Center Sanford. The call center is available 24 hours a day, seven days a week. Historically, referring care teams contacted each location separately to determine if an appropriate bed was available. Today, IP BH OneCall saves time and reduces duplication of effort by providing a central, coordinated process to assess the patient’s needs and locate an inpatient bed in real time. Timely behavioral health inpatient admissions move people from busy emergency rooms to the next appropriate level of care.

As a shining example of leveraging System expertise and resources, IP BH OneCall has significantly improved patient experience. In a year’s time, crisis admissions to MHBHSH and MHMMCS doubled. Importantly, the service has reduced ED length of stay for behavioral health patients seeking inpatient level of care by 4.5 hours and that downward trend is expected to continue as additional hospitals join the referral process.

“I am really passionate about helping our patients and community by expeditiously moving patients from the ER to the appropriate level of care. Being able to coordinate across the system with various care team members has been very gratifying and leads to better care for our patients. In addition, I believe this has led to better partnerships between locations,” said Matthew Meserve, RN, OneCall Transfer Center Specialist.

The OneCall Team:

Right bed, right time:

Decreased ED length of stay:

Decreased ED length of stay: