Document Type


Publication Date

Winter 1-22-2016



Transforming Care of the Behavioral Health Patient in an Emergency Department Setting


Theresa J. Kubiel

MSN, Walden University, 2009

BSN, Bloomfield College, 2002

AAS, Ocean County College, 1992

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

January 2016


Behavioral and mental health issues contribute to the needs of many patients presenting to emergency departments, and yet these needs often go unrecognized. Patient processing procedures in emergency departments may not include mechanisms to consistently identify and triage patients whose care is complicated by behavioral illness. The purpose of this project was to plan a program to improve early identification and management of behavioral health patients presenting to the emergency department. The objective of this project was to develop a rapid mental health screening tool and policies guiding use of the tool in the emergency department. A multi-disciplinary team of emergency department providers cooperated in the selection and evaluation of available screening tools. A literature search was done with the inclusion criterion of behavioral screening tools to be used at time of triage, and results were brought to the team for further consideration. The HEADS-ED pediatric screening tool was chosen through the expert opinions of the team members. The team evaluated and approved adaptations to the tool for its use in adults. Policies were developed to guide the future implementation of the screening tool in the emergency department. A plan for process and outcome evaluation was included in the developed program. Process will be evaluated by monitoring provider use of the screening tool, and patient length of stay in the emergency department will serve as the outcome measure. The program may contribute to social change through improved emergency department care of patients with behavioral illnesses.