Clinical Component

Patient-Centric Psychiatric Facility: High Demand, Unique Challenges, and Ongoing Transition to Cerner

You will be covering 14 patient beds each shift, seeing an average of 16 patients per day with an average of 2 discharges and 2 admissions per day. You will not do any admitting after 3:45 pm to ensure that you are not staying late finishing an admission. One hour is typically allotted for admission. Ninety-nine percent of patients arrive from the ED via ambulance and close to 100% of their admissions are involuntary. The current population is 30%-40% Medicaid patients and they also take on complex and highly aggressive patients.    

They are transitioning to Cerner, but that process is expected to be in place by Spring 2024. You do have the option to take on a scribe and they will assign a current member of your staff as your scribe, but that will come at a cost to you, and you will have the option to cover additional beds to help offset this cost. They do have Nuance and Dragon to dictate notes, but documents still must be printed out and placed in the paper record. They also utilize HCS to put in orders and prescriptions. 

There is very little competition at either facility. At Fuller Hospital specifically, due to its proximity to Rhode Island, many of the nearby facilities cannot compete for patients since they are in a different state. Right now, all the inpatient hospitals in Massachusetts are running near capacity and their current hospitals have a 70-person daily waitlist so there is no shortage of patients. They shared with us that many patients are held in the EDs until a bed opens a Psychiatric facility.  

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