St. Vincent Charity Medical Center, which is a ministry of the Sisters of Charity Health System, has had to adapt how it delivers care to patients, and that's especially evident in caring for patients with serious behavioral health concerns. Health Progress, a publication of the Catholic Health Association of the United States, recently highlighted how St. Vincent Charity has quickly reworked how it provides behavioral health care.
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By Betsy Taylor
At a time when the global coronavirus pandemic has just about everyone feeling some level of anxiety or sadness, St. Vincent Charity Medical Center in Cleveland, like hospitals elsewhere in the nation, rapidly reworked its provision of care to patients with serious behavioral health concerns. St. Vincent has a long history of providing a lifeline for patients with mental illness, addiction or both.
Even as the medical center had to adapt many aspects of care to prevent the spread of potential infection, staff also moved swiftly to make technology changes so that counselors are still able to hold individual and group therapies for patients at their regular times. By using telephone calls and computer meet-ups, rather than face to face gatherings, St. Vincent has been able to serve most of those patients who normally came into the facility for on-site counseling.
A quick pivot
Michael J. Biscaro, PsyD, ABPP, said staff knew that those with substance abuse disorders and/or mental health conditions “can get lost, or fall through the cracks,” and they understood it was essential to get behavioral health services to those in need. Biscaro is chief of behavioral health and addiction services for St. Vincent Charity Medical Center. The medical center, which had already been working to better integrate primary care and behavioral health, to expand the continuum of care to better link patients to needed care and services in a variety of settings, and to expand peer support services, was able to quickly pivot to offer increased telehealth services in just the last few weeks.
Infection prevention, while maintaining services
On site, behavioral health patients admitted for care are now one to a room, rather than the usual two patients to a room, to reduce infection risks. And employees have adjusted to more stringent recommendations for sanitizing of facilities and establishing social distancing between patients including in smaller, but more frequent, on-site therapy groups. Medical changes have been implemented as well, such as patients having their temperatures taken more frequently than usual to try to catch potential cases of new infection early, Biscaro said. (As of April 2, St. Vincent Charity Medical Center was treating two patients who were admitted because they were positive for COVID-19, with a third patient’s results pending.)
Orlando Howard is director of outpatient treatment services and quality improvement for Rosary Hall, the substance use disorder treatment center at St. Vincent Charity Medical Center. He said clients of the medical center’s behavioral health services have made it clear they need those services at this stressful time. He read from several client statements, with their approval to share with the media. Participants confirmed that having their usual group therapy sessions set the tone for the day and allowed them to feel like they had something proactive to do for their well-being, as well as needed support, while they maintain sobriety. One man said he “probably wouldn’t have been all that OK” without the continuation of counseling through phone and computer links. “It’s not the technology. It’s the people behind the technology,” he said.
Those staff providing behavioral health services have not had to change the way they talk with clients or the information they share, although the Rosary Hall website has been updated with information about virtual group meetings and other resources.
In some cases, it took extra work for clinicians to practice moving sessions online, to make sure staff was comfortable with the technology, said Howard, and arranging for back up contact numbers for clients, should an electronic connection go down. No changes to billing or to the law were needed to move the telehealth offerings forward, said Biscaro. Before joining St. Vincent Charity Medical Center earlier this year, Biscaro had been with the VA Northeast Ohio Healthcare System since 2009. The VA has robust telehealth offerings, Biscaro noted, so the transition to manage the use of more telehealth was familiar to him.
A tradition of care
St. Vincent Charity Medical Center is part of the Sisters of Charity Health System. In the mid-19th century, the Sisters of Charity of St. Augustine were asked to provide health care in Cleveland for the ill and injured, including wounded soldiers returning from the Civil War. The sisters started caring for patients at St. Vincent beginning in 1865. The hospital often sees patients whose medical and behavioral cases are complex. The hospital has one of two psychiatric emergency departments in the state of Ohio, which treats about 4,000 patients annually, Biscaro said. About a quarter of those patients are admitted as inpatients. The medical center has two 24-bed psychiatric wards (one is currently under renovation), an additional 16 beds for patients over the age of 50 with geriatric psychiatric needs, 27 beds in its Rosary Hall detoxification unit, as well as outpatient programs and a partial hospitalization program. It coordinates with other organizations when patients need residential programs or wraparoud social services.
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