NOCHS, agencies reflect on partnership one year later

Krystle Wagner • Dec 18, 2017 at 10:00 AM

A little more than one year has passed since North Ottawa Community Hospital’s new emergency room was fully opened.

Since then, officials from the North Ottawa Community Health System and its collaborating partners say they’ve bolstered relationships and are working to treat the whole patient.

In addition to the brick-and-mortar changes, the health system changed the way patients are assessed.

Jen VanSkiver, the health system’s spokeswoman, said they were seeing an increase in patients presenting outright and underlying mental health problems and challenges with basic needs. She said that some patients had underlying mental health issues that prevented them from getting better. For example, someone would enter the ER with chest pains and leave being diagnosed with anxiety.

With the new model of care, dedicated social workers are in the ER from 9 a.m. to 8:30 p.m. Monday through Friday, and 10 a.m. to noon and 4-7 p.m. on weekends and holidays. Those times are based on analysis to when there was the highest volume of patients needing mental health services entering the ER.

Instead of receiving a brochure with resources and numbers to call, social workers directly connect patients with collaborating agencies.

TCM Counseling Executive Director Sarah Lewakowski said the collaboration with NOCHS is important because they were seeing the same clients, but clients didn’t directly go to TCM for services. Now, when patients seek care for mental health issues in the ER, social workers contact TCM. Patients can either drive to TCM for an intake session or be seen in a private ER room that’s similar to a living room.

Being able to meet with patients in the ER for an intake and discuss with them about who their therapist will be “makes a huge difference,” Lewakowski said. With 45 therapists on staff, she said they’re able to see clients right away.

Lewakowski said the partnership has been “remarkable and reciprocal.”

Additionally, there are times when a client needs to be treated in the ER — if they plan to harm themselves or can’t promise they will remain safe.

Previously, it was difficult to speak with a client about going to the ER, but Lewakowski said it has become better now because of services and having the ability to see a social worker right away. About four referrals a week are made out of the ER to TCM Counseling.

The Love in Action Free Health Clinic is also seeing an increase in patients they serve as a result of the new ER model and strengthening their collaboration. There is an average of 14 referrals a month from the hospital to the clinic, which offers services for individuals ages 18 and older who either can’t afford care or don’t have health insurance.

Although the Love in Action Free Health Clinic has worked with NOCHS since the beginning, clinic director Jody Buttery said the changes dove-tail into the clinic’s expansion. The clinic is now open 12-4 p.m. Monday through Friday, and by appointment Tuesday mornings and Thursday evenings.

The health clinic works with ER social workers to determine which patients they can help. Buttery said the goal is to get patient referrals and help them whether they’re seeking care for a sore throat or earache, or because they don’t have a primary care physician.

“We wanted to be that extra safety net for people so they wouldn’t overutilize the emergency room for reasons not needed,” Buttery said. “It’s costing the community, it’s costing the hospital, and it’s costing the patient first and foremost.”

The open communication has been beneficial in connecting with patients and helping direct them to services. Buttery said they also work to help clients get health insurance and a primary care physician with the North Ottawa Medical Group.

Through the years, the local health system has worked to recruit and grow primary care physicians. 

In January, NOCHS formed a partnership with Forest View Hospital in Grand Rapids. Through the partnership, NOCHS has access to Forest View’s medication clinic and patients can receive psychiatric assessments and services. Scott Miles, director of community relations for Forest View, said it allows residents to receive the “right place and at the right time.”

Even though Forest View Hospital is in Grand Rapids, few patients have not shown up for appointments, said Cynthia VanKampen, chief nursing officer for NOCHS.

Miles said NOCH is the only ER he’s seen that has mental health “safe” rooms, which have doors that come down from the wall and cover items that could be used by a patient to harm themselves or others.

Looking ahead, VanKampen said they plan to continue to grow their partnerships, recruit primary care physicians, see what the community needs and provide those services.

TCM Counseling will also provide Question, Persuade and Refer (QPR) training for employees in the medical group.

VanSkiver said they’re in a constant state of evaluation, and what’s next is based on continuing to collaborate and work together.

“I speak on behalf of our executive team and our board when I say that North Ottawa’s success is 100 percent dependent upon the success of our collaborating partners, because there’s a limit to what we can do, but there’s no limit to what we can achieve together when we have a community plan,” she said.

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