XFERALL’s power is demonstrated in two ways. One is through our mobile transfer platform. In the palm of their hands, clinicians have the ability not only to identify available care resources for a patient needing transfer but also to facilitate the transfer quickly and efficiently.
The second way is through our data tracking and analytics reporting.
XFERALL tracks and reports data on the number and type of transfer denials by facility and the reasons for denial as well as time-to-transfer as an indicator of which patient profiles are the most challenging to place and which are boarding in hospital emergency departments the longest. For example, are pregnant patients taking longer to place in behavioral health facilities because of their physical health needs? Are patients who are agitated or engaging in destructive behavior in the ED harder to place? Do patients who are involved in the legal system have the longest boarding times?
Having data, rather than anecdote, to answer these questions is essential to identify where care gaps exist and where limited public resources would most effectively be spent to augment capacity.
We talk about the difficulties in finding an “available bed” for behavioral health patients, but that is shorthand that obscures the fact that what is needed for each unique patient is a specific type of facility with specific care resources to provide treatment for their diagnosis and circumstance. Patients presenting in hospital emergency departments with behavioral health needs do not all present with the same symptoms, clinical history and profile, or demographic characteristics.
For example, a 14-year-old English speaker with a history of an eating disorder who is self-harming has different treatment needs than a 65-year-old, Spanish speaker with schizophrenia and diabetes. Just knowing that there is an available empty psychiatric bed somewhere is insufficient to know if that bed is at a facility with the appropriate specialists and resources for a patient’s unique clinical and demographic profile.
Likewise, when states invest resources to add psychiatric beds to the health care system, they have to know what type of beds are needed and where. Are beds/care resources needed more for pediatric patients? For geriatric patients? For behavioral health patients with co-existing medical conditions, such as diabetes? For forensic patients?
We know from our work that most patients needing inpatient behavioral health care are denied admission not because of a global lack of available beds in a market but because of the lack of the specific type of bed/care resources needed to manage their particular clinical issues.
Simply increasing the number of psychiatric beds in a market or geographic region is unlikely to solve completely the very real behavioral health care capacity problem. Specific types of beds are required if we want to eliminate care gaps, reduce ED boarding times, and get people into treatment more quickly. XFERALL’s data shines a light on those gaps to guide focused solutions.