A protocol to reduce police wait times in the emergency department

Abstract

Healthcare organizations are increasingly tasked with implementing change initiatives that improve the patient experience and target priorities such as Emergency Department (ED) volumes. This article describes the development, implementation, and outcomes of a collaborative protocol between the Niagara Health System and the Niagara Regional Police Service that resulted in a 57% reduction in police wait times in the ED. Six critical success factors contributed to the outcomes that were achieved and are detailed for those organizations interested in engaging in a similar change initiative.

Get full access to this article

View all access options for this article.

References

Lundy

Morin

. Project leadership influences resistance to change: The case of the Canadian public service. Proj Manag J. 2013;44(4):45–64. doi:https://dx-doi-org.web.bisu.edu.cn/10.1002/pmj.21355.

Ransdell

. Personal reflections on leadership for change: An invited article. Int J Leadership Change. 2014;2(1):1–8. Available at: http://digitalcommons.wku.edu/ijlc/vol2/iss1/1. Accessed November 6, 2014.

Conteh

. Strategic inter-organizational cooperation in complex environments. Publ Manag Rev. 2013;15(4):501–521. doi:https://dx-doi-org.web.bisu.edu.cn/10.1080/14719037.2012.674424.

Merrell

. Effective change management: The simple truth. Manag Serv. 2012;56(2):20.

Groysberg

Slind

. Leadership is a conversation. Harvard Bus Rev. 2012;90(6):76–84.

MacPhee

Chang

Lee

Spiri

. Global healthcare leadership development: Trends to consider. J Healthc Leader. 2013;5:22–29. doi:https://dx-doi-org.web.bisu.edu.cn/10.2147/JHL.S23010.

Brännmark

Benn

. A proposed model for evaluating the sustainability of continuous change programmes. J Change Manag. 2012;12(2):231–245. doi:https://dx-doi-org.web.bisu.edu.cn/10.1080/14697017.2012.672449.

Mental Health Act (1990). The Service Ontario Web site. Available at: http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_90m07_e.htm. Accessed November 12, 2014.

Provincial Human Services and Justice Coordinating Committee (2011). Police and mental health: A critical review of joint police/mental health collaborations in Ontario. Available at: http://www.hsjcc.on.ca/Provincial/Police%20and%20Mental%20Health%20Project/Police%20and%20Mental%20Health%20-%20A%20Critical%20Review%20of%20Joint%20Police-Mental%20Health%20Collaborations%20in%20Ontario.pdf. Accessed November 2, 2014.

10.

Altzema

Schull

Kurdyak

. Wait times in the emergency department for patients with mental illness. CMAJ. 2012;184(18):E969–E976. doi:https://dx-doi-org.web.bisu.edu.cn/10.1503/cmaj.111043.

11.

Llewellin

Arendts

Weeden

Pethebridge

. Involuntary psychiatric attendances at an Australasian emergency department: A comparison of police and healthcare worker initiated presentations. Emerg Med Aust. 2011;23(5):593–599. doi:https://dx-doi-org.web.bisu.edu.cn/10.1111/j.1742-6723.2011.01448.x.

12.

Slade

Dixon

Semmel

. Trends in the duration of emergency department visits, 2001-2006. Psychiatr Serv. 2010;61(9):878–884. doi:https://dx-doi-org.web.bisu.edu.cn/10.1176/appi.ps.61.9.878.

13.

Clarke

Dusome

Hughes

. Emergency department from the mental health client’s perspective. Int J Ment Health Nurs. 2007;16(2):126–131.

14.

Lamb

Weinberger

DeCuir

. The police and mental health. Am Psychiatr Assoc. 2002;53(10):1266–1271.

15.

Human Services and Justice Coordinating Committee Ontario (2013). Ontario police-emergency department protocols. Available at: http://www.hsjcc.on.ca/Resource%20Library/Policing/Ontario%20Police%20Emergency%20Department%20Protocols%20-%202013.pdf. Accessed November 2, 2014.

16.

Gerdtz

Weiland

Jelinek

Mackinlay

Hill

. Perspectives of emergency department staff on the triage of mental health-related presentations: Implications for education, policy and practice. Emerg Med Aust. 2012;24(5):492–500. doi:https://dx-doi-org.web.bisu.edu.cn/10.1111/j.1742-6723.2012.01592.x.

17.

Lee

Brunero

Fairbrother

Cowan

. Profiling police presentations of mental health consumers to an emergency department. Int J Ment Health Nurs. 2008;17:311–316. doi:https://dx-doi-org.web.bisu.edu.cn/10.1111/j.1447-0349.2008.00553.x.

18.

Wooden

Air

Schrader

Wieland

Goldney

. Frequent attenders with mental disorders at a general hospital emergency department. Emerg Med Aust. 2009;21(3):191–195. doi:https://dx-doi-org.web.bisu.edu.cn/10.1111/j.1742-6723.2009.01181.x.

19.

Knott

Pleban

Taylor

Castle

. Management of mental health patients attending Victorian emergency departments. Aust N Z J Psychiatry. 2007;41(9):759–767.

20.

Ministry of Health and Long Term Care (2014). Ontario’s emergency room wait time strategy. Available at: http://www.health.gov.on.ca/en/pro/programs/waittimes/edrs/strategy.aspx#2. Accessed November 8, 2014.

21.

Niagara Health System and Niagara Regional Police Service. Mental Health Act Apprehension and Care of Persons in Custody Protocol. St Catharines, Ontario, Canada: Author; 2014.

22.

Hoffman

. Development of the interRAI brief mental health screener to enhance the ability of police officers to identify persons with serious mental disorder. The University of Waterloo Library Database. Available at: http://hdl.handle.net/10012/7497.2013. Accessed November 6, 2014.

23.

InterRAI (2014). Emergency Screener for Psychiatry (ESP). Available at: http://www.interrai.org/emergency-screener-psychiatry.html. Accessed November 22, 2014.

24.

InterRAI (2014). Mental Health for Inpatient Psychiatry (MH). Available at: http://www.interrai.org/mental-health.html. Accessed December 11, 2014.

25.

Gomez-Mejia

Balkin

. Management (8th ed). New York: McGraw-Hill; 2002.

26.

McShane

Von Glinow

. Organizational behavior: Emerging realities for the workplace. New York: The McGraw-Hill Companies; 2005.

27.

Hirdes

MacKenzie

. Brief Mental Health Screener [Application]. Available at: http://healthinformaticsmobile.com/index.html. Accessed November 22, 2014.