Date of Conferral

2021

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara Niedz

Abstract

The DNP project was a quality improvement evaluation of an emergency department (ED) response system for psychiatric patients. The identified problem within the organization was a breakdown in care for psychiatric patients in the ED. The practice-focused question was twofold to address whether: (a) the development of a new ED response team would significantly reduce ED wait times, positively affect the left without being seen (LWBS) rates, and improve patient satisfaction for psychiatric patients and (b) the development of a new emergency room response team would improve the perceptions of ED staff on the process. The context, input, process, and product evaluation model was used to sum up the value the program and its impact on the organization. Sources of evidence were used to address the practice questions and include length of stay in the ED, LWBS rates, patient satisfaction survey, and staff survey. Evidence from published research was used and other sources of evidence included project site archival and retrospective data. Findings indicate that the programmatic changes improved LWBS rates from an overall percentage of 1.5% to 1.2% during the evaluation period. There was a significant improvement in staff satisfaction with an overall mean score for the 2017 of 18.73 and the overall mean score for the 2020 of 38.2. A Wilcoxon Signed Ranks test indicated that the higher mean score on the 2020 questions was statistically significant when compared to the 2017 scores (Z = -3.463, p < .001). Findings and recommendations were provided in a presentation to senior leaders of the organization. Implications for positive social change include greater awareness regarding mental illness, greater access to care, and recovery oriented-patient centered care.

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