Carolinas HealthCare System

Virtual Care Helps Behavioral Health Alleviate Length of Stay in EDs

Nehal P. Thakkar, MD

John Santopietro, MD
Chief Clinical Officer of Behavioral Health

Across the country, the volume of psychiatric patients seeking treatment in emergency is on the rise. As demand for urgent mental health services has increased, it’s become necessary to create a delivery model that properly places behavioral health patients, frees beds for medical emergencies and cuts costs in one of the most expensive parts of the healthcare system.

Carolinas HealthCare System’s behavioral health team, under the leadership of John Santopietro, MD, chief clinical officer of behavioral health, and Martha Whitecotton, senior vice president of behavioral health, has implemented a program that shifts people with mental health needs out of emergency rooms and into the care of a medical team trained to treat them in an effective and timely manner.

“We are growing a virtual team created of people who truly care and are knowledgeable about our behavioral health patients,” Whitecotton said.

The multi-disciplinary virtual team consists of a registered nurses, social workers, therapists and physicians who work with each patient and their families to coordinate appropriate and individualized care.

Nehal P. Thakkar, MD

Martha Whitecotton
Senior Vice President of Behavioral Health

When Dr. Santopietro arrived at Carolinas HealthCare System in March 2013, his goal was to create a model that decreased the length of stay in emergency departments while delivering optimal care to patients.

“We started a database to track how long behavioral health patients were waiting in emergency rooms across the System,” Dr. Santopietro said. “We saw that some were waiting as long as nine days – the psych patient was last in line to receive help.”

The team initiated a centralized behavioral health patient placement program across EDs in the Charlotte metropolitan area. Facilities that are part of the program receive telepsychiatry services, proper patient placement to a facility with an open bed and transportation services that compassionately take the patient from the ED to their destination.

This model has proven to be hugely successful in the short amount of time it’s been in place. In July 2014, over 480 patients were relieved from ED’s and placed in behavioral health facilities.

“This process is a tremendous benefit to both the medical EDs and our behavioral health patients,” Whitecotton said. “The patient appreciates that everyone is looking out for them and they know they are getting treatment right away instead of waiting.”

Learn more about the System’s Behavioral Health Home