Date of Conferral

3-6-2025

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Management

Advisor

Eboni Green

Abstract

Due to an increase in the presentation of adults with mental health crises and substance use disorders in rural emergency departments (EDs), solutions should focus on the enhancement of patient outcomes, improving the quality of care, health conditions, and overall patient experience. The purpose of this integrative review was to synthesize international evidence associated with initiatives to improve ED care identified through the concepts of the Donabedian framework model that can support ED managers in implementing evidence-based interventions to improve behavioral healthcare in rural EDs. An integrative review of literature published between 2019 and 2024 was conducted. The findings of the thematic analysis identified three key themes that address the improvement of care: (a) organizational processes, (b) procedural improvements, and (c) improving outcomes. These three key themes can be impactful in detecting the root cause of bottlenecking, stagnation, and inefficiency of patient flow and throughput. They can also decrease wait times and ED boarding, improving timeliness in the delivery of care and enhancing patient satisfaction and regulatory compliance while reducing ED overusage and readmission rates through the usage of measurable performance indicators while simultaneously managing and reducing costs. Drawing from the concepts of Donabedian’s model, ED managers can equip staff with specialized behavioral health training and resources needed to manage behavioral health crises, standardize interventions to improve the quality of care and enhance behavioral healthcare outcomes. Improving behavioral healthcare in the ED can promote healthcare equity, reduce stigma, and improve health outcomes for this patient population.

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