Crisis Reliability Indicators Supporting Emergency Services (CRISES): A Framework for Developing Performance Measures for Behavioral Health Crisis and Psychiatric Emergency Programs

Abstract

Crisis and emergency psychiatric services are an integral part of the healthcare system, yet there are no standardized measures for programs providing these services. We developed the Crisis Reliability Indicators Supporting Emergency Services (CRISES) framework to create measures that inform internal performance improvement initiatives and allow comparison across programs. The framework consists of two components—the CRISES domains (timely, safe, accessible, least-restrictive, effective, consumer/family centered, and partnership) and the measures supporting each domain. The CRISES framework provides a foundation for development of standardized measures for the crisis field. This will become increasingly important as pay-for-performance initiatives expand with healthcare reform.

The Impact of the COVID-19 Pandemic on Psychiatric Emergency Service Volume and Hospital Admissions

“…We lack data on restraint, seclusion, and length of stay to describe how the course of care in the ED may have changed due to the pandemic. 14 …”

“…These services diagnose and manage psychiatric presentations in the ED setting in order to reduce ED length of stay, avert psychiatric hospitalizations, and promote recovery in less restrictive treatment settings. 13 Through their capacity to treat high acuity patients and monitor the quality of behavioral health care delivered, 14 these services offer a unique resource for providing accessible, high quality psychiatric care to communities underserved by mental health providers. 15 …”

Provider-Payer Partnerships as an Engine for Continuous Quality Improvement

“…Comparing fiscal years 2016 and 2017, there was a 30% decrease in 72-hour return visits to the observation units, dropping from 1.6% to 1.1% of youths (p,.03) and from 3.3% to 2.2% of adults (p,.02) (72-hour return visits are defined as the percentage of patients discharged from the observation unit who return to the observation unit within 72 hours, as described previously [3]). There was a 50% decrease in the percentage of adults discharged from the inpatient unit who were readmitted to the inpatient unit within 30 days, from 5.5% to 2.8% (p,.01).…”

Using the police cell as intervention in mental health crises: Qualitative approach to an interdisciplinary practice and its possible consequences

“…Equity in access to acute mental health care is internationally a major challenge 30 but low threshold access to crisis care is highly appreciated by patients and their families 31 . This is confirmed by the current findings.…”