•PR: – The “Patient Flow Standard” and the 4-Hour Recommendation[®] [Ref: GB, LDR, MDx, RNx] Perspectives, June 2013, Pg 1, Vol 33, #6

Effective January 1, 2014, there will be two enhancements to the requirements for managing patient flow as called for in LD.04.03.11.  Although these standards focus primarily on the timely movement (or lack thereof) of patients in emergency rooms, it has been clearly established that it is also applicable to the general timeliness of care issues in our psychiatric hospitals (e.g., assessments, lab, consultations).  A new note attached to EP#4 recommends 4 hrs. (based on extensive research and field reviews) as the maximum time duration for boarding.  New EP#9 is even more germane to our hospitals.  It requires hospitals that are at risk for boarding patients with psychiatric emergencies to communicate with behavioral health care providers.  This might well include state psychiatric hospitals.
Tip:  Be on the look out for opportunities to renegotiate and improve the coordination of care with your general hospital referral sources under the impetus of EP#9.
Tip: Review PC.01.02.03, EPs 1-8, PC.01.02.15, EPs 1-3 and PC.02.02.01, EPs 1-3, 10, 17 for additional requirements relevant to Patient Flow
Key Def: Boarding – the practice of holding patients in an ED or other temporary location after the decision to admit or transfer has been made.