ECMC says it is taking steps to improve overwhelmed mental health ER

The Erie County Medical Center said its overwhelmed behavioral health ER, which is under state investigation, stems from dynamics playing out across the state and across the country, as the Buffalo hospital has had problems with staffing challenges and the inability to quickly discharge patients.

Faced with complaints from patients that they waited up to three days in a crowded observation room at ECMC’s mental health emergency unit before being seen by a psychiatrist, ECMC said Monday it has taken a series of steps in recent months to try to address concerns about their comprehensive psychiatric system. Emergency Program, or CPEP.

This has included the implementation of a plan to communicate with patients and their families, verbally and in writing, information related to the CPEP processes upon arrival and upon admission. The Buffalo hospital also said it has provided CPEP staff with additional education and tools to “use compassionate communication throughout the CPEP process and how to assess and meet all patient needs.”

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And, when possible, patients with non-emergency problems are referred to the hospital’s Outpatient Help Center, where doctors can help connect them with the appropriate outpatient services and supports.

Jeff Brown and his wife Laura Shriver-Brown describe Jeff’s experience when he ended up in ECMC’s Comprehensive Emergency Psychiatric Program after a mental health episode.

Those were some of the steps that ECMC said its clinical patient care liaison disclosed in a June letter to an 18-year-old patient, whose parents had raised concerns after she spent about 30 hours in CPEP over the weekend. Memorial Day before she was seen. a staff doctor. That was the same patient whose story was shared by Republican county lawmakers in a June 16 letter to ECMC Corp. President and CEO Thomas J. Quatroche, in which lawmakers asked the hospital to provide a report on “What, if any, systems failed on your daughter and what will be done moving forward to improve this critically important program.”

ECMC’s CPEP operation has also recently come under fire after members of the ECMC nurses union last week posted an online video of embattled behavioral health employees confronting department administrators over tailored staffing plans. Christmas and New Years weekends are coming up. After the video went viral, several former patients contacted The Buffalo News to share their stories of visiting CPEP.

Buffalo mental health ER is overwhelmed as patients and families question conditions

The Buffalo News interviewed several patients in recent weeks who painted a stark portrait of what they experienced at ECMC’s Comprehensive Emergency Psychiatric Program.

Some patients said they waited up to three days to be evaluated at a CPEP unit that is the only “safety net” mental health emergency department in the Buffalo Niagara region, except for a much smaller unit at Niagara Falls Memorial. Medical Center.

Joseph C. Lorigo, Minority Leader for the Erie County Legislature, said the video of the nurses and the stories of the patients validate the concerns that Republican lawmakers raised in their letter to Quatroche.

Lorigo said he never received a direct response from anyone at ECMC about the letter. Meanwhile, ECMC said it did not respond in writing to the Erie County Legislature’s minority conference, but asked an ECMC board member to copy the letter to communicate with lawmakers.

“I haven’t gotten a response from anyone at ECMC, not from Tom Quatroche, not from anyone on the board, nothing. It’s concerning,” Lorigo said. “And for a hospital that’s supposed to be a public benefit hospital, it’s unacceptable, really.”

Erie County Medical Center Corp. is governed by a board of 15 voting directors, eight of whom are appointed by the Governor and seven by the County Executive. There are also four non-voting directors: the chief executive officer of the corporation, a director selected by the county executive, and a director selected by the majority and minority leaders of the county legislature.

After viral video, state Department of Health investigates conditions in ECMC's psychiatric emergency unit

Those familiar with ECMC’s Comprehensive Emergency Psychiatric Program say it has long been a harrowing experience for patients and staff, but conditions have deteriorated as the pandemic waves lasted into this year and staff decreased.

Daniel Meyer, a spokesman for Erie County Executive Mark C. Poloncarz, said the county Department of Mental Health has been closely monitoring the situation at CPEP for months.

“Mental Health Commissioner Mark O’Brien, along with key community partners, have been meeting with families and patient advocates to hear their concerns,” Meyer said in a statement. “Commissioner O’Brien has taken the lead in organizing a community engagement group that will meet on an ongoing basis with behavioral health administrative and clinical leadership and senior hospital leadership at ECMC to address concerns/complaints related to with the CPEP”.

In addition, Meyer said, the Department of Mental Health has been coordinating a number of initiatives to “build community-based CPEP crisis diversion alternatives, as well as options for heavy CPEP users to be served in the community.”

Asked if the county has asked CPEP to put enough chairs in its waiting areas so that patients are not sitting and sleeping on the floor when the unit is occupied, Meyer said the county has “advocated and remains optimistic about the physical improvements that are being made in the waiting room. space area designated for patients”.

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Gov. Kathy Hochul’s office said her administration is monitoring the situation at ECMC’s CPEP. The state is in the process of building a “comprehensive crisis response system” that includes new intensive crisis stabilization centers designed to provide immediate care for those experiencing a behavioral health crisis and divert them from unnecessary ER visits. .

After the viral video from the New York State Nurses Association, the state Department of Health said it has “initiated an investigation into this matter.” The Department of Health has declined to comment further.

The video was posted at a time when the union is negotiating a new contract for more than 1,300 registered nurses at ECMC.

Lona DeNisco, a longtime registered nurse at ECMC’s ER, said the union aims to bolster staffing throughout the hospital, including CPEP. The current contract expires on December 31.

“We as nurses are definitely striving to improve that,” DeNisco said. “Because the nurses are top notch, it’s not that you don’t have qualified nurses, but you don’t have the number of nurses to do the job right. They can’t treat that many patients, you can’t do checkups on 25 patients, 50 patients, like it’s impossible to do it and still have that therapeutic component to stabilize someone.”

ECMC said it has hired 39 CPEP staff this year. In addition, seven new CPEP nurses will start soon once they complete their orientation, said the hospital, which is seeking to fill 12 currently available nursing positions in the program.

Jon Harris can be reached at 716-849-3482 or Follow him on Twitter at @ByJonHarris.

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