The Patient Safety Measures order for ED patients will now default to Behavioral Health Supervision Per Policy. This order is available as a stand-alone order or available in the following powerplans:

• ED Transition of Care Mental Health
• ED Behavior
• ED Violent or Self-Destructive Behavior Restraint

Historically, the EDs have used 1:1 observation for all patients with any mental health complaint. Determining the appropriate level of observation will enable us to allocate our resources more appropriately.

The Columbia-Suicide Severity Rating Scale (C-SSRS) will be used to determine the patient’s suicide risk level during the ED rooming assessment. Answers to the C-SSRS questions will assign the ED Indicated Risk Severity. This will enable us to provide the appropriate level of suicide observation at the start of an ED visit until patient is evaluated by a Social Worker. Reference Policy #357.

Note: CSAs will continue to provide 1:1 supervision for behavioral health patients on inpatient floors.

The observation type in use will be captured in hourly charting and can be seen on the IView documentation flowsheet