This project is a quality improvement initiative aimed to reduce unwarranted and unnecessary ED utilization for psychiatric crisis as well as enhance support to primary care team members around patients presenting with acute psychiatric and/or high risk symptoms. Through the use of a synchronous Epic-based secure chat group, we effectively reduced the volume of 911 calls for such crises and diverted to more suitable, right-sized, and patient-centered community resources. Utilization of the secure chat, combined with direct feedback, demonstrates high degree of satisfaction with support tool both for clinical management as well as learning and ongoing professional development for our primary care team members.
Kristin Koberstain, PhD, LMFT, Senior Instructor, Psychiatry & Family Medicine, University of Rochester School of Medicine, Rochester, NY; Traci Terrance, PhD, Associate Professor, Psychiatry, Clinical and Translational Research, & Family Medicine, University of Rochester School of Medicine, Rochester, NY
Okafor N, et al. Impact of Primary Care Mental Health Management on Emergency Psychiatric Presentations: A Systematic Review. Cureus, December 2025. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812239/
Piette A, et al. Interventions to Reduce Repeat Presentations to Hospital Emergency Departments for Mental Health Concerns: A Scoping Review of the Literature. PMC, 2023. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10138571/
Reducing "Avoidable" ED Visits for Mental Health Could Cut Billions in Costs, Improve Patient Outcomes. American Journal of Managed Care (AJMC), 2022. Available at: https://www.ajmc.com/view/reducing-avoidable-ed-visits-for-mental-health-could-cut-billions-in-costs-improve-patient-outcomes