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

Sequence of actions
Each element of the change project would be introduced on the Monday and
evaluated on the following Friday through the medium of feedback from staff. This would
allow for corrective action to be taken where the feedback recommended it as necessary. It
was hoped that the constant and regular feedback would maintain the momentum and
guarantee a sense of purpose and importance to staff feedback. Although the project was
specifically designed for use in the ED there was a requirement to have regular
communications with the psychiatry team. The liaison psychiatry clinical nurse manager’s
feedback was of huge significance because of her specialist knowledge and this input was
channelled through to the frontline staff and change teams.
Resource Requirements
It was noted that IT would be the main resource required after the frontline staff to
facilitate the implementation plan. However due to circumstances they were unavailable to
provide support on the first week of the implementation phase. It had been arranged that the
computerised pop-up screen was to be the first element set in motion but owing to the
situation we found ourselves in, the decision was made to introduce the Mental Illness Triage
Tool. A commitment was given by IT that the computerised pop-up screen would be in place
for week three of the implementation phase.
Risks
The main risk identified was that due to the delay in the installation of the computer
element this would possibly give rise to delays with the triage of patients while staff became
familiar with the new triage tool. The change teams proposed a solution in that if the triage
nurse found that if there were time delays in triage, the clinical nurse manager would be
contacted and an extra nurse would be deployed to assist with other triage presentations. This
was put to the clinical nurse managers and they were supportive of this proposal. It was
pointed out that these delays would not be long-term and it was only a matter of staff
becoming familiar with the new triage system.
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