Development and Implementation of a Collaborative Model to Improve Emergency Psychiatric Patient Outcomes

2.50
Hdl Handle:
http://hdl.handle.net/10755/162892
Type:
Presentation
Title:
Development and Implementation of a Collaborative Model to Improve Emergency Psychiatric Patient Outcomes
Abstract:
Development and Implementation of a Collaborative Model to Improve Emergency Psychiatric Patient Outcomes
Conference Sponsor:Emergency Nurses Association
Conference Year:2003
Author:Tyrell, Ann Marie, RN, MS, CEN
P.I. Institution Name:New Hanover Regional Medical Center
Contact Telephone:910/343-2503
Co-Authors:Joyce Winters, RN, MSN; and Jane Goldsworth, RN, MSN
Clinical Topic: The intent of this clinical project was to develop and implement measurable improved clinical outcomes for psychiatric patients seen in the emergency department. Psychiatric patients had very long lengths of stay in the ED. Much of that time was spent waiting for medical clearance to be completed before psychiatric intervention and planning would begin. This stepwise process was inefficient and occasionally exacerbated the patient symptoms. Patients who were placed through the regional psychiatric placement program were frequently lost to referral at our network psychiatric hospital. Recidivism of psychiatric patients discharged from the ED was reviewed. This identified the need for more comprehensive referrals on discharge from the ED. Implementation: A collaborative team model for the Emergency Department and Acute Psychiatric Services was developed. The Plan, Do, Study, Act (PDSA) model was used. Eight working sessions were planned. The team identified the need to improve the process for placing patients in the acute psychiatric system. The team was lead by the nursing directors of psychiatry and emergency. The team members included the managers of both emergency departments and the psychiatric screening services, and coordinators from all shifts and sites. Outcome measures were developed. Procedures were drafted to streamline: 1) Early psychiatric screening of psychiatric emergency department patients by increased presence of psychiatric screeners in the emergency department. 2) The Medical care and/or clearance of the patient presenting to the psychiatric unit. 3) Tools were developed to facilitate communication among nurses along the continuum of care. The Medical Clearance form provides relevant past medical and psychiatric history as well as needed elements for psychiatric admission. Outcomes: Improvement in patient care was demonstrated by: 1) ED LOS for psychiatric patient decreased from 6 hours 12 minutes to 3 hours 34 minutes; 2) ED patients transferred to the psychiatric unit increased from 77 per month to 127 per month; 3) average daily census in the Acute Psychiatric Unit increased from 34.6 to 36.9; and 4) a Referral Resource Guide was designed to support patient follow up upon discharge from the emergency department. Recommendations: The team recommended continued presence of screeners in the
emergency department. Additional education for both psychiatric and emergency department nurses was identified. Lastly, the team recommended that we expand the focus of the project to include the regional mental health organization. This collaborative model brought together nursing specialists in psychiatric and emergency care to provide a more complete overview of the needs and problems experienced by patients. In addition to improved quality of care for a specialized population, the enhanced communication between the two disciplines had lead to improved problem solving to meet individual patient needs. [Clinical Poster]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDevelopment and Implementation of a Collaborative Model to Improve Emergency Psychiatric Patient Outcomesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162892-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Development and Implementation of a Collaborative Model to Improve Emergency Psychiatric Patient Outcomes</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Tyrell, Ann Marie, RN, MS, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">New Hanover Regional Medical Center</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">910/343-2503</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Atyrell@nhhn.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Joyce Winters, RN, MSN; and Jane Goldsworth, RN, MSN</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: The intent of this clinical project was to develop and implement measurable improved clinical outcomes for psychiatric patients seen in the emergency department. Psychiatric patients had very long lengths of stay in the ED. Much of that time was spent waiting for medical clearance to be completed before psychiatric intervention and planning would begin. This stepwise process was inefficient and occasionally exacerbated the patient symptoms. Patients who were placed through the regional psychiatric placement program were frequently lost to referral at our network psychiatric hospital. Recidivism of psychiatric patients discharged from the ED was reviewed. This identified the need for more comprehensive referrals on discharge from the ED. Implementation: A collaborative team model for the Emergency Department and Acute Psychiatric Services was developed. The Plan, Do, Study, Act (PDSA) model was used. Eight working sessions were planned. The team identified the need to improve the process for placing patients in the acute psychiatric system. The team was lead by the nursing directors of psychiatry and emergency. The team members included the managers of both emergency departments and the psychiatric screening services, and coordinators from all shifts and sites. Outcome measures were developed. Procedures were drafted to streamline: 1) Early psychiatric screening of psychiatric emergency department patients by increased presence of psychiatric screeners in the emergency department. 2) The Medical care and/or clearance of the patient presenting to the psychiatric unit. 3) Tools were developed to facilitate communication among nurses along the continuum of care. The Medical Clearance form provides relevant past medical and psychiatric history as well as needed elements for psychiatric admission. Outcomes: Improvement in patient care was demonstrated by: 1) ED LOS for psychiatric patient decreased from 6 hours 12 minutes to 3 hours 34 minutes; 2) ED patients transferred to the psychiatric unit increased from 77 per month to 127 per month; 3) average daily census in the Acute Psychiatric Unit increased from 34.6 to 36.9; and 4) a Referral Resource Guide was designed to support patient follow up upon discharge from the emergency department. Recommendations: The team recommended continued presence of screeners in the <br/>emergency department. Additional education for both psychiatric and emergency department nurses was identified. Lastly, the team recommended that we expand the focus of the project to include the regional mental health organization. This collaborative model brought together nursing specialists in psychiatric and emergency care to provide a more complete overview of the needs and problems experienced by patients. In addition to improved quality of care for a specialized population, the enhanced communication between the two disciplines had lead to improved problem solving to meet individual patient needs. [Clinical Poster]</td></tr></table>en_GB
dc.date.available2011-10-27T10:35:55Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:35:55Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.