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Implementation of Nurse-Driven Standardized Protocols to Reduce Behavioral Health Patients' Length of Stay Within the
Judy Haefner1, Jaclyn Wolf2, Suzette Goff3
1University of Michigan-Flint, Flint, Michigan.
Background:
Patients presenting to the ED, with behavioral health crises in the United States, are frequently held for hours to days awaiting evaluation, medical clearance, and transfer to a behavioral health facility or discharge from the ED. Extended boarding of behavioral health patients can create an unsafe and potentially dangerous environment, placing additional demands on EDs.
Objective:
Identify and improve processes that delay treatment for mental health patients in the ED.
Methods:
A nurse-driven protocol was created to reduce wait times and length of stay for the behavioral health patients in the ED setting. The protocol has nursing initiate orders to reduce the time for ordering labs to receiving lab results leading to more timely medical clearance of behavior health patients.
Results:
Over a 2-month time frame there was decrease in mean minutes from arrival of the patient to laboratory/diagnostic orders being placed and labs results available (time Pre N = 27.16 minutes; time Post N = 23.47 minutes;(p = .171). While not significant, there was an overall decrease in mean minutes of diagnostic results which decreased medical clearance minutes from pre-to post-implementation (time Pre N = 253.46 minutes; time Post N = 114.74 minutes; p = .546).
Discussion:
While not statistically significance behavioral health patients experienced decreased length of stay in the ED creating improved patient care.
Implication For Nursing:
The expansion of the nursing role through standardized protocols provides appropriate and timely care to behavioral health patients.
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