RamaOnHealthcare August 7, 2024
Helping Patients Receive the Right Care in the Right Setting
Today, RamaOnHealthcare talks with Dominique Wells, MSN, RN, COO, Conduit Health Partners, which specializes in nurse-led triage, patient transfer, and health care engagement and outreach solutions for hospitals, health systems, and employers.
Dominique Wells, MSN, RN, COO, Conduit Health Partners
RamaOnHealthcare (ROH): Welcome to our Thought Leadership series, Dominique. Could you tell us about yourself and Conduit Health Partners?
Dominique Wells (DM): I’ve wanted to be a nurse for as long as I can remember and knew on-the-job experience was a great way for me to better understand the ins and outs of healthcare. But finding a hospital position proved to be challenging. There weren’t a lot of openings at the time. But I was determined and drove from hospital to hospital, resume in hand, looking for any role to allow me to kickstart my health care journey.
At the third hospital, I told the HR director, “I’ll take anything you have.” With pride, I accepted a housekeeper position and advanced to becoming a Patient Care Technician, Phlebotomist, and finally a Registered Nurse. My career didn’t stop there. I worked my way to Nurse Manager and then explored an interest in Clinical Informatics, first as a clinical content specialist and later as a Nursing Information Officer.
Today, as Chief Operating Officer for Conduit Health Partners, I oversee operational leadership, innovation, and the technology road map for the company. Conduit is Nurse-driven and Nurse-led. We provide services to connect patients to the right care at the right time. This includes Nurse first triage, patient transfer services, and health care engagement and outreach. We manage more than 1.7 million patient cases across the nation since inception for hospitals, health systems, Federally Qualified Health Centers, rural health clinics, employers and more.
In my work with Conduit, I am especially skilled at uncovering ways to deliver better care at a lower cost. Most recently, we’ve seen success in strengthening access to care, safety and health outcomes for behavioral health patients through our Nurse transfer service.
…we’ve seen success in strengthening access to care, safety and health outcomes for behavioral health patients through our Nurse transfer service.
ROH: Talk to us about the challenges hospitals face today in providing timely care to behavioral health patients. And – what challenges do emergency departments (EDs) face in particular?
DM: It’s no secret the number of people who struggle with mental health challenges is rising and affecting people of all ages.
Last year, a study by the Centers for Disease Control and Prevention found mental health-related ED visits among children ages 5 to 17 increase significantly at the start of a new school year. The reasons for these visits range from depression to suicidal thoughts, difficulties managing stress, and substance use disorder. In fact, among children and teens, rates of mental health and spending for mental health services have risen sharply in recent years.
And among adults, research shows more adults struggle with mental health stressors, whether from long-term stress or temporary stressors, anxiety, or depression, according to the American Psychological Association. Younger adults—those ages 18 to 34 currently have the highest rate of mental health disorders. Adults ages 35 to 44 show the highest increase in mental health diagnoses among adults.
Behavioral health challenges affect people physically and mentally. That’s part of why so many people experiencing a behavioral health crisis end up in the ED. For example, it can be difficult to determine whether symptoms such as chest pain or stomach pain have a physical cause or are stress related. Another reason EDs see a growing number of behavioral health cases is due to the shortage of behavioral health providers. Today, one out of three people live in an area with a shortage of mental health professionals. This leaves patients and family members feeling as though they have no choice but to go to the ED for care.
Behavioral health challenges affect people physically and mentally.
ROH: What are the challenges EDs face when patients come to them for help with behavioral health issues?
DM: EDs aren’t designed to provide behavioral health care. For one, the ED is a stressful environment. For a patient experiencing anxiety, waiting hours for care in a crowded place and where any number of health emergencies may be occurring at the same time can ultimately add to the distress they feel. For another, EDs typically don’t have the right staff on hand to provide mental health care in the moment. They also face difficulty connecting with professionals who are best suited to provide behavioral health services. This results in long waits for care.
In instances where a patient can be diagnosed, the lack of an available inpatient bed may result in the patient waiting in the ED for hours or days. This situation has gotten so common, one state health department ordered hospitals to end behavioral health boarding in the ED by 2025.
ROH: From your point of view, what is the solution to this crisis?
DW: Our experience at Conduit Health Partners points to the value of hospitals and health systems collaborating with an outside partner to facilitate timely transfer of acute behavioral health patients. It’s an approach that strengthens safety for patients, visitors and health care staff while improving health care outcomes by helping patients receive the right care in the right setting.
It’s an approach that strengthens safety for patients, visitors and health care staff while improving health care outcomes….
We know EDs across the nation struggle to manage the number of patients including behavioral health patients seeking services, and there are growing concerns regarding ED wait times and hours spent boarding patients. These are challenges hospitals and health systems are ill-equipped to tackle on their own because they lack the staff, the specialized expertise, and the space to do so effectively.
By working in partnership with a Nurse-driven patient transfer service, health systems can streamline care transfers of behavioral health patients from the ED to appropriate care settings. In doing so, they can develop a care process that fosters better communication, consistency, and trust by centralizing the information. It’s critical to determine what the patient needs right now—and how the patient’s needs would best be served beyond the immediate crisis.
ROH: Which organizations are making strides in reducing ED boarding times for behavioral health patients? What are the results you’re seeing?
DM: One organization where streamlined transfer for behavioral health patients is making a difference is Mercy Health — Springfield Regional Medical Center, located in Springfield, Ohio. Like many EDs across the country, the organization faced significant challenges transferring patients with acute behavioral health needs to the right setting and level of care in a timely manner. This slowed down the care process for patients most at risk.
Starting in February 2023, Conduit worked with this organization to design workflows to improve the transfer process by putting data in the hands of hospital-based clinicians. This enabled the team to identify opportunities and manage patient volumes and avoid delays in care delivery. We worked collaboratively with the hospital team to revamp ED transfer workflows for behavioral health patients. A bedside checklist empowers Nurses to generate an electronic request for a behavioral health bed in the EHR. The request automatically alerts Conduit when assistance from our Nurse-led patient transfer service is needed, saving significant time and resources.
…Conduit worked with this organization to design workflows to improve the transfer process by putting data in the hands of hospital-based clinicians.
The results have been outstanding. In just two months, Mercy Health — Springfield Regional Medical Center achieved a 64% reduction in ED length of stay for behavioral health patients, speeding time to treatment and improving the safety of patients and staff. The new workflows also resulted in a 27% reduction in average phone calls from Conduit, which had previously provided patient transfer services to the hospital, as well as a 50-seconds-per-call reduction in talk time during transfer calls. Based on the success of this initiative, Bon Secours Mercy Health has introduced this approach in multiple markets, including two EDs in Toledo and 10 EDs in Cincinnati. Additionally, plans are in place to roll out to six more EDs in Toledo in the coming year and explore implementation at other locations within the system.
…Mercy Health — Springfield Regional Medical Center achieved a 64% reduction in ED length of stay for behavioral health patients….
ROH: What are you learning from initiatives like this about the potential to leverage information and health tech to drive better care for behavioral health patients in the ED?
DW: Our partnership with Mercy Health — Springfield Regional Medical Center points to the value of centralized information and streamlined processes in fostering communication and consistency among care teams. When ED care teams can rely on a data-driven, tech-enabled approach for signaling the need for a behavioral health bed, this takes the weight off the nurse to track down an available bed. It also helps reduce travel times for patient transport teams by ensuring the bed assignment that results from this request is the closest and best option for care based on the patient’s needs. We’re excited by our partnership with Mercy Health — Springfield Regional Medical Center and look forward to expanding this model to other communities in the Springfield region.
More About Dominique Wells
Dominique takes a strategic approach to shaping organizational strategies that strengthen patient care while reducing care costs.
Over the past three decades, she has accumulated extensive experience in clinical and nursing leadership. She has consistently driven clinical standardization initiatives, streamlined processes, and fostered collaborative partnerships, resulting in significant cost savings for multi-hospital health systems. Her expertise in clinical informatics has been instrumental in implementing innovative healthcare delivery methods, in part by leveraging the EHR to its fullest potential.
Dominique holds a Nursing degree from The Christ Hospital School of Nursing, a Bachelor of Science in Nursing from The Ohio University, and a Master’s degree in Nursing executive leadership from Northern Kentucky University.
In her role as COO for Conduit Health Partners, Dominique is committed to driving operational excellence, promoting business growth, and aligning organizational objectives with strategic initiatives. She is known for her ability to foster effective change management and drive transformative outcomes in complex healthcare environments.
Outside of work, Dominique enjoys journaling, a practice she learned from her mother.
Dominique’s LinkedIn: https://www.linkedin.com/in/dominique-wells-02605071
Her Conduit bio: https://www.conduithp.com/personnel/dominique-wells
Conduit: https://www.conduithp.com
Conduit Health Partners
Conduit Health Partners is a health care solutions company that connects patients and employees to the care they need, when they need it, through customized services in patient transfer, Nurse triage, remote patient monitoring, including hospital at-home and patient outreach. With innovation at the forefront, Conduit is an operational partner that improves care and access for health systems, provider groups, health plans and employers via cost-effective, efficient solutions delivered by more than 120 Nurses in 50 states. Conduit has improved access to care for more than 1.7 million people since its inception in 2017.
Learn more at https://www.conduithp.com