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Opening a New Inpatient Mental Health Unit: Where to Start?

By Jon Guzman posted 02-07-2018 07:47 PM

  
​Greetings APNA Community,

I will be opening an Adult  Inpatient Mental Health Unit this Summer and wanted to start a forum to ask for input on where to start. Below is a list of items I've thought of. Any and all input will be greatly appreciated! 

- State Regulations on Involuntary Holds / Riese Medication
- Mental Health appropriate equipment (e.g. non-ligature point racks/beds, restroom, etc.)
- Joint Commission recommendations

Respectfully,

Jon
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02-24-2018 07:23 AM

Hi Jon,

Very exciting and I am happy to help. I have been working on an adult In-Pt MHU for 7 years. Several of those years I was the Director. So I am familiar with all the ins and out of what you are doing. Due to some organizational restructuring of my entire hospital I have stepped back into a staff nurse role.
Any event for the Physical Plant/appropriate equipment aspect you need to start with the Behavioral Health Design Guide ( http://www.bhfcllc.com/download-the-design-guide/ ) It is free to download and gives resources as to where to get all the equipment I.E. ligature resistant door handles, BH rated toilets, fixtures, etc, etc. It also gives you some idea as to how you wish to lay out the floor. For example one piece of advice I can give you there would be to make the Nursing station and medroom part of the Dayroom. This prevents a geographic division between the Nurses and the patients and a staff division between the Nurses and your Techs. This helps to ensure your staff work as a team and minimizes a Nurse VS Tech culture because everyone is forced to work in the same geographical location.
I spent the last 4 years or so upgrading our facility. All of our furniture has been swapped out for BH rated furniture. We use a mixture of Spec (http://www.specfurniture.com/seating/heavy-duty-seating?1=#!/866) and Norix (http://www.norix.com/behavioral-healthcare-furniture.asp) in our Dayroom. Spec is a bit less institutional looking and their products are weighted. Only Norix is used in our Bedrooms. And for our Dining Hall, I went with Norix's bolted down Oasis Cafe tables (http://www.norix.com/oasis.asp)
As for the delivery of care my recommendation is to reference the Joint Commission Accreditation Manual (https://www.jointcommission.org/standards_information/edition.aspx) Are you part of a larger hospital or will you be a stand alone BH hospital? Why I ask is if you are part of a larger hospital, you will use the Hospital Manual. If you are stand alone you will need to use the Behavioral Health manual. However that being said, even though we are part of the larger hospital, I prefer the BH manual as a guide because it is more specific to BH and is more rigid in its standards. As for state and local you will need to check locally with all of that but I can tell you that most organizations bow down to the mighty Joint Commission and fall in line with their "suggested" regulations. In Florida, behavioral health is licensed by and regulated by the Department of Children and Families (DCF). If you have a similar agency in your neck of the woods, in addition to the Joint Commission manual, I would start there. I would also push to keep your Nurse to Pt ratio 1:6 and your Tech to Pt ratio 1:6. Standards for Social Work tend to be 1:10.
Well I hope this helps. I know its a lot to digest. Should you have any other questions please feel free to reach out. Thanks!
Rob
zatara74@yahoo.com

02-13-2018 01:11 PM

Hi Jon, I don't know much about opening a new unit, however, I am working on an SBIRT project, which is now part of the HBIPS for psychiatric inpatient facilities. An SBIRT implementation could, I guess, be included in the start-up plans! Bobbi