The MHA believes that data can improve patient care, reduce costs and make healthcare more efficient. This section includes data used to inform MHA’s policy and advocacy initiatives and resources that can help hospitals and health systems use data to improve their operations.
Behavioral Health Boarding Survey
The United States is facing a behavioral health crisis and Michigan is no exception. There are record numbers of behavioral health patients waiting in hospital emergency departments (ED) throughout the state for an available hospital bed. However, Michigan lacks the necessary number of behavioral healthcare workers and treatment facilities to meet the demand of patients needing inpatient care. Not only are behavioral health patients not receiving the care they need in an appropriate setting, but it causes a series of complex problems for hospitals, ranging from increased wait times for patients in the emergency department to inadequate reimbursement. The MHA aims to bring awareness to the issue and pursue legislation to ease the burden on member hospitals and health systems while getting behavioral health patients the care they need.
Boarding occurs when a behavioral health patient waits in an ED or another unit until a behavioral health bed is available. The MHA started collecting data in March 2023 on ED boarding on a weekly basis from member hospitals and health systems. Hospitals and health systems provide data on the number of patients waiting to receive a behavioral health evaluation and the total number of patients boarding in an ED awaiting an inpatient psychiatric bed.
The MHA will be sharing the data that is collected in aggregate on a weekly basis.
Data for Nov. 20, 2023
Hospitals Reporting Behavioral Health Census Data
|Patients in an ED awaiting a Behavioral Health Bed||Patients in a hospital facility awaiting a Behavioral Health Bed||TOTAL number of patients awaiting a Behavioral Health Bed|
Number of Patients Waiting for a Behavioral Health Bed in Michigan Hospitals
Point in Time Survey of Michigan Hospitals
Hospitals Completing Behavioral Health Boarding Survey
Point in Time Survey of Michigan Hospitals
Should the survey be completed by a hospital or health system? Why is this important?
A separate survey response should be completed for each hospital in the health system (e.g., for seven hospitals within one system, seven separate surveys should be completed). Having each hospital within a health system complete this survey allows for varying demographics and trends within the data to be identified and accounted for. However, one individual can complete multiple surveys on behalf of several locations.
Who should be completing the survey?
Preferably emergency department (ED) directors or management coordinators. Other roles within the hospital with available data may also complete the survey on a weekly basis.
When should the survey be completed?
The survey should be completed once a week on Mondays.
What is the standard definition of boarding for psychiatric patients?
Boarding describes patients who are (1) awaiting an evaluation in the ED, (2) evaluated in the ED but not admitted, or (3) evaluated but spending extensive time in inappropriate locations – whether in the ED or in another equally unsuitable place – while awaiting voluntary or involuntary psychiatric hospitalization. Overall, boarded patients are NOT formally admitted, and they are NOT patients in an inpatient bed.
We have a separate psych ED. Should we include those patients in the survey?
Please include these patients within the survey response if they are either waiting for an evaluation or waiting for a behavioral health bed, whether they are in the general ED or psych ED.
Are patients who are in the process of a transfer considered a boarded patient?
No, please do not include these patients in the survey response.
At what point in the process of medical clearance should a person be ‘counted’ in the survey?
When a patient needs a behavioral health bed but no behavioral health bed is available.
Michigan hospitals and health systems continue to experience staffing shortages that became more severe due to the pandemic. Many vacancies were due to unscheduled and abrupt employee retirements, resignations and reduced hours due to burnout and increased rates of violence against healthcare workers. State workforce grants have significantly assisted hospitals in reacting to the healthcare workforce crisis and provided stability to the industry. However, a survey completed March 2023 by 95% of the MHA membership continues to show the significant staffing vacancies in hospitals throughout Michigan. Overall, Hospitals have more than 27,000 current job openings, including nearly 8,500 open nursing positions. These vacancies are specific to hospitals and do not include nursing homes, physician practices or other healthcare providers.
Hospitals have significant job openings in both clinical and non-clinical positions. The number of job openings creates a cascade of problems, from longer wait times in the emergency department, reduced services and more difficulty transferring patients to the appropriate care setting.
Michigan hospitals are missing 13% of the workforce they need, including in areas that are critical to patient care. These include behavioral health professionals, nursing, patient care techs and clinical assistants.
Hospitals are one of the largest employers in many Michigan communities. Collectively, they employ 208,000 full and part-time employees.
Nearly 8,500 nursing positions are currently vacant out of 62,000 nursing positions in Michigan hospitals. Hospitals and health systems remain committed to solving this crisis and are investing in innovative programs to address and improve the supply of nurses through higher education partnerships. They are committed to increasing the number of new professionals entering the workforce, offering current employees opportunities for higher education and skills advancement, and increasing workplace flexibilities.
Visit our Healthcare Workforce webpage for more information.