Clinician perspectives of a mental health consumer flow strategy in an emergency department

Abstract

Background: The increasing number of presentations to hospital emergency departments has seen the implementation of a variety of strategies in an effort to enhance care delivery and care continuity. One such strategy was designed and implemented to improve the transition of mental health consumers presenting to an Australian emergency department and admitted to a hospital mental health ward. Aim: The aimofthispaper is topresentthefindings of a study that exploredclinicianperceptions regarding the implementation of a mental health consumer flow strategy. Methods: This was a qualitative study. Semi structured interviews were conducted with four emergency and four mental health clinicians employed at the hospital. Findings: Three key themes emerged regarding the consumer flow strategy. ‘Bridging the care provision gap’ revealed a lack of shared understanding between departments, insufficient education and lack of process consistency that impacted on care provision. ‘Ownership of and responsibility for consumers’ revealed misunderstandings about ownership of the person with a mental illness in the emergency department. ‘Dissonance in expectations of quality and timely care’ revealed that the quality and timeliness of care was impacted by physical, organisational and communication barriers. Discussion: Findings suggest that the implementation of the consumer flow strategy was supported in principal by clinicians. However, to improve the process and foster a shared understanding between departments, the provision of recurring education and adequate resources was required. Conclusion: This paper identifies the complexities of introducing a new process to two hospital departments.