Improving Quality of Care for Psychiatric Patients in the Emergency Department

Thesis (M.Nurs.), College of Nursing, Washington State UniversityThe U.S. emergency health care system has become the primary access point for many people with mental illness, but is poorly equipped to meet the needs of patients experiencing psychiatric crises, and may actually cause them additional harm. The purpose of this paper is to review literature on psychiatric care in emergency departments and suggest strategies to improve quality and outcomes, using Betty Neuman's Systems Model of nursing and the Institute of Medicine Quality Chasm Report's six aims for high quality health care as guidelines. Changes in practice and environment are necessary to improve the experiences and outcomes of patients in psychiatric crises, and psychiatric nurses are a critical component in the process, for providing patient advocacy, detecting and preventing iatrogenic crises, and assisting in development of quality measures. Even in a less-than-optimal environment, a focus on safety and patient-centered care of psychiatric patients in crisis can improve outcomes as well as patient and staff experiences