Decreasing Demand in Emergency with SAFE STEPS

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Two people standing outdoors in a park, with trees and buildings in the background. One person is wearing a suit, and the other is in a blue top.
Divisional Director for Mental Health at PAH and EMF clinician-researcher, Associate Professor Manaan Kar Ray

A mental health research project at Princess Alexandra Hospital is stepping up the delivery of care for consumers in the community while decreasing the number of patients attending the Emergency Department.

Divisional Director for Mental Health at PAH and EMF clinician-researcher, Associate Professor Manaan Kar Ray, is leading the Emergency Medicine Foundation (EMF) funded SAFE-STEPS project which aims to evaluate the innovative approach and create a blueprint for other emergency departments to replicate.

The mental health service at PAH uses a common language of care; AIMS (Assessment, Interventions, Monitoring, Step Up / Down), to define the goals of current treatment.

Treating teams use the framework to collaboratively decide when enhanced care is needed. This is supported by a transition coordinator who serves as a lynch pin across the system, ensuring direct or rapid admissions bypassing ED or intensive treatment in the community.

A/Prof Kar Ray said this timely detection and early support in the community for mental health patients who are deteriorating not only decreases patient and family suffering, but also decreases the need to present to the Emergency Department in crisis. 

“We are confident these systems can proactively identify and support deteriorating mental health patients before they reach ED,” A/Prof Kar Ray said. 

“We saw a 66 per cent decrease in ED presentations from patients engaged by the Acute Care Team in 2023 compared to the previous year.”

This reduction in presentations has a significant benefit for those patients who do present to the ED for mental health care and the teams who treat them.

“In January this year, the Mental Health section of PAH’s Emergency Department clocked an impressive 1 hour 12 minutes average length of stay which is a significant reduction.” 

A/Prof Kar Ray said SAFE-STEPS would help understand how this was achieved and provide a blueprint for other Mental Health Services and EDs to replicate the success of Princess Alexandra Hospital.

A/Prof Kar Ray presented at the Queensland-wide Emergency Medicine Foundation’s (EMF) research symposium this month, which showcased the latest research tackling ED congestion.