Dr. Matthew Chow, MD, FRCPC

Sarah Robertson, Manager Telehealth Services, IMITS

March 2017

Nothing to disclose Dr. Matthew Chow

Vancouver is in the grip of a mental health crisis

the number of people apprehended by police under the Mental Health Act is rising

The VPD are handling about 33 mental health-related calls a day.

St. Paul’s Hospital facing nearly 68,000 emergency visits each year that have a mental health component.

50-70% of patients who are taken to hospital by first-responders (including the police) are discharged soon after being seen by a physician

Police as first responders to persons in mental health crises have three options:

resolve the situation informally,

apprehend the person under the Mental Health Act and transport to a designated facility,

or arrest and charge the person with a criminal offence.

February-24-17 5

$320,000

$60,000

February-24-17 6

Police officers use video collaboration software to connect on-demand to nurse specialists and doctors in the hospital during encounters with individuals experiencing a mental health crisis.

These clinical specialists will interview the officer and client remotely, as well as assess the client’s environment to gather important collateral information that will assist with the subsequent in-hospital assessment.

Providing clients with,”The right care at the right time in the right place”..

divert clients away from emergency departments and directly to a more suitable community resource; better serving the client.

More efficient use of police resources, by reducing the time it requires making disposition decisions both in the field and when clients are at SPH.

Vancouver is the first place in the world where healthcare professionals,

patients, and front-line police officers have the opportunity to communicate in

this way.

Low

ris

k

PDSA Cycle #1

- every

patient

brought to

hospital for

second

assessment

Mediu

m R

isk

PDSA Cycle #2 -

patients

streamed to

outpatient

resources without

coming to

hospital, who will

be followed up by

Car 87 the

following day

Mediu

m R

isk

PDSA Cycle #3

-physician-

directed

interventions

provided

without

coming to

hospital

Vancouver resident age 17 or older

Candidate for a Section 28, but the decision to apprehend is unclear

Able to speak clearly and respond to direction

Those whose behavior should be observed – include those participants for whom the health care team would benefit from observation

Monday October 17th, 2016 to November 25th, 2016, 6 week pilot

1 RPN from St. Paul’s, 11 VPD officers

First 2 weeks available 0730 – 1530, next 4 weeks available 1530 - 2330

1. Technology

2. Training and Organization

3. Acuity of clients at St. Paul’s

( appropriateness of Teletriage)

All those who participated in the project strongly endorse this project and believe in the potential for it to improve efficiency and outcomes

This project improved communication and relationships between hospital staff and police

Technology needs to be simple and easy to use and support needs to be straightforward and easily accessible

The high acuity of patients who are brought to St. Paul’s hospital do not meet the eligibility criteria for this service.

Incorporate lessons learned from PDSA Cycle #1 into Cycle #2

Launch PDSA Cycle #2 in Spring 2017

Dr. Matthew Chow

Matthew.chow@outlook.com

Questions??