Date of Conferral

7-30-2026

Date of Award

July 2026

Degree

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

School

Health Sciences

Advisor

Dr. Matt Frederiksen-England

Abstract

Delays in inpatient psychiatric admissions represent a significant and persistent challenge within U.S. behavioral health systems, contributing to emergency department boarding, reduced quality of care, increasing risk, resource strain, and inefficiencies. The purpose of this integrative review was to examine evidence-based operational strategies that improve intake efficiency and reduce admission delays in inpatient behavioral health facilities. The Lean Healthcare Framework was used, which emphasizes eliminating waste, improving workflow efficiency, and enhancing value. The review question focused on what operational and systems-management evidence-based strategies are most effective in improving intake efficiency. The Johns Hopkins Evidence-Based Practice appraisal tool was used to appraise 30 sources identified through the review process. Following the quality appraisal, 21 sources were included in the thematic analysis. Three primary themes were identified: (a) standardizing and optimizing intake processes, (b) optimizing workforce and care team design, and (c) improving capacity management and system-level coordination. Nine subthemes were identified, including the key subthemes of standardized triage protocols, streamlined documentation, centralized intake coordination, targeted staff training, and the use of technology to improve patient flow. Based on these findings, recommendations include implementing standardized intake workflows, strengthening workforce capacity through dedicated roles and targeted training, and adopting dynamic capacity management strategies to improve patient flow and reduce delays. These findings support positive social change by addressing social determinants of health, including access to care, resource availability, and health equity, ensuring timely and equitable behavioral health services for underserved populations.

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