Improving the Assessment and Triage of Patients with Mental Illness ...

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Manchester Triage System. This data was used to collect information on the difference in triage allocation using two separate “tools” of assessment and did not include any patient details in the analysis. When collecting data for audit, ethical considerations need to be assessed to protect both patients and staff (National Institute of Clinical Excellence (N.I.C.E), 2002). The triage nurses were willing participants in this small scale study and were informed prior to the data collection the purpose of this data collection. It was arranged that following implementation of the pop-up screen there would be an analysis of triage times again to determine if the new processes reduced triage times. This was one of the objectives for the introduction of the “tools”. Finally a date for implementation of the project was agreed and this was arranged for the first week in March. Methods of the communication of the change management project were arranged. A brief informal session of approximately ten minutes duration took place each morning following handover to highlight the change project. These brief sessions would capture the majority of staff on day and night shifts. This took place over a two week period prior to implementation. Focus groups arranged dates for further meetings, the information on these were posted on the staff notice board. Staff were also furnished with e-mail contacts of the members of the change team. All members of staff were invited to attend and requested to e- mail items for attention prior to the meetings in relation to questions regarding the change project. Cooper and Benjamin (2004) counsel that continuous consultation and reassurance of staff is significant and suggests highlighting how the change will impact on the organisation is of great significance and needs to be reinforced at every opportunity. The clinical facilitators in the ED received information packs containing the documents and a power point presentation regarding the change project. They were requested by the change agent to outline and discuss the change initiative in their induction of new staff and also to highlight its importance to postgraduate students. The change teams would participate in educational sessions, communicating the progress of the change project and the vision. 26
Developing the implementation plan. The development of the implementation plan was crucial at this stage of the process. The meetings arranged for the last two weeks in February informed all key stakeholders about the progress of the change project and how near to readiness it was in terms of implementation which included the confirmation of a start date for the change project. The majority of stakeholders were enthused at the prospect of the impending change however there were a select group that remained unconvinced and resistant to the change initiative. As change agent I felt the onus was on me to get buy-in from those resistant and I attempted to establish their trust by further communication of the vision, the benefits to patients and staff and the importance of their involvement in the change initiative. They were encouraged to voice their fears and concerns. Success of change depends on the change agent’s ability to communicate and their skills of negotiation alongside the expert power they possess (Cartwright and Baldwin, 2007). The decision was made to phase the three elements of the project in over a period of three weeks so that staff had time to adjust as other changes happening within the ED. Achieving change or otherwise depends on individuals’ perceptions on the way it was handled along with the pace of the change which can hinder success (Furst and Cable, 2008) Elements of the Implementation/ Project Plan Scope of the change Assessing the scope of the change was done in collaboration with the three project change teams and the change agent. It was believed to be attainable within the designated time frame. In establishing a consensus on the timeframe several elements were considered including the amount of staff on annual leave, sick leave, the readiness and availability of the IT support team, and the fact that there were no other projects under way at this time. The change teams would all be available in order to offer support to all staff during this transition from the old to the new. The ED consultants were informed of the commencement date and the sequence of events and were very supportive. 27
Page 1 and 2: Royal College of Surgeons in Irelan
Page 3 and 4: Improving the Assessment and Triage
Page 5 and 6: Abstract Since the amalgamation of
Page 7 and 8: Table of Contents Abstract Acknowle
Page 9 and 10: Chapter 1 Introduction 1.1 Introduc
Page 11 and 12: However there are a large number of
Page 13 and 14: Chapter 2 The Literature Review 2.1
Page 15 and 16: with mental health issues, who pres
Page 17 and 18: Australia. The data was collected b
Page 19 and 20: Following implementation of the Nat
Page 21 and 22: Consequently the subsequent chapter
Page 23 and 24: must analyse their surroundings and
Page 25 and 26: After consideration of the aforemen
Page 27 and 28: questioning the patient about their
Page 29 and 30: The benefits of successful implemen
Page 31 and 32: Establishing trust was significant
Page 33: Group One: Nursing documentation- C
Page 37 and 38: Communication As discussed in relat
Page 39 and 40: Nevertheless as a change agent and
Page 41 and 42: crucial. The change agent or change
Page 43 and 44: The observational audit carried out
Page 45 and 46: Limitations arise as the project wa
Page 47 and 48: 5.5 Conclusion Improving the triage
Page 49 and 50: Cartwright, T., Baldwin, D. (2007)
Page 51 and 52: Happell, B., Summers, M., Pinikahan
Page 53 and 54: McAuliffe, E., Van Vaerenbergh, C.
Page 55 and 56: National Institute for Clinical Exc
Page 57 and 58: Wand, T. (2004) Mental Health Liais
Page 59 and 60: Appendices Appendix A Mental Illnes
Page 61 and 62: Appendix A Mental Illness Nursing A
Page 63 and 64: Appendix C Recommendations in World
Page 65 and 66: Appendix E Manchester Triage Algori
Page 67 and 68: Appendix G Health Service Executive
Page 69 and 70: Appendix I Change Management Projec
Page 71 and 72: Appendix K Mental Illness Triage To
Page 73 and 74: Appendix M Force Field Analysis Dri
Page 75 and 76: Appendix O Questionnaire results re
Page 77: Appendix Q 16 Triage Category alloc

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