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Case Study

Police, Ambulance and Clinical Early Response (PACER)

5 Minute Read

Overview

The challenge

Many behavioral health patients are brought to the emergency department (ED) by police unnecessarily.

The organisation

The Victoria Department of Health is an Australian state-level department that manages the Victorian public hospital system, community health, ambulance, and dental services.

The approach

The Victoria Department of Health began a partnership between hospitals, the police department, ambulance service, and behavioral health services to try to reduce inappropriate ED presentations.

The results

The PACER model expedites treatment to behavioral health patients by bringing the behavioral health clinician to the patient. Moreover, the police first responders are cleared to leave the scene once the PACER team arrives, freeing up police resources.

 

Approach

Under PACER, the Victoria Department of Health partners a behavioral health clinician with a police team to better address behavioral events. This helps to mitigate ED demand and ensure behavioral health patients receive the appropriate care more quickly.

The behavioral health clinician is based in the police department or remains in hospital and is on call for the duration of an eight hour shift. The clinician accompanies the PACER police team when responding to a behavioral call.

Once on scene, the clinician is able to assess the person and determine the best course of care. In many cases, the clinician is able to de-escalate the situation and connect them to available services in the community, thereby avoiding a trip to the emergency department.

Should the clinician determine that hospitalization is necessary, the patient is fast-tracked to the behavioral health ward, space permitting, again avoiding the emergency department.

 

Results

How we know it works

Significantly fewer patients have been brought to the emergency department since PACER began, reducing emergency department demand.

66%

Decrease in time to behavioral health assessment
and time to clear first responder unit from scene 

33%

Decrease in length of stay for behavioral health
patients in the emergency department

Taken together, these two improvements have had a real impact on patient flow in crowded emergency departments.

But the PACER model also expedites treatment to patients by bringing the behavioral health clinician to the patient. The patient is assessed sooner, enhancing safety and quality. Moreover, the police first responders are cleared to leave the scene once the PACER team arrives, freeing up police resources as well. This decrease represents a drop from about three hours to just under one. While these metrics are impressive, they also represent a model of care that is better for the patient from a quality and experience standpoint.

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