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

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Mainstreaming Feedback from the clinical nurse managers was positive in support of the computerised pop-up screen and the Mental Illness Triage Tool; however there were issues with the nursing assessment documentation. It was suggested staff would find it more user friendly if it was combined with the other nursing assessment documents in booklet form. At the initial stage of the implementation process slight delays were noted with the triaging of patients however with constant supervision and encouragement from the change teams, the waiting times were reduced. The clinical nurse managers expressed how staff appeared more confident in their assessment of patients with mental illness and more assured in their interactions with the psychiatry services. Many clinical nurse managers felt there had been a reduction in the number of complaints and incidents regarding patients with mental illness. The elements of the change project have been taken on and improvements have resulted. Kotter (1996) suggests that the approach to change and its implementation are as important as the support from influential senior management. 3.6 Conclusion This project focused on the implementation of a change in the triage and assessment of patients with mental illness in the ED. The change process was undertaken by utilising the components of the HSE (2008) change model. The model provides for a structured approach and helps to focus activities for the change agent and change teams. Recognition of the need for change and communication of the need in a clear concise manner is very important. Involving staff from the outset is essential and reduces the levels of resistance for change. An establishment of trust helps in the transformation from the old to the new way of doing things. Change needs to be developed in such a way that it is understood and managed so that staff are able to cope with the transition. There needs to be a certain level of urgency about the need for change and therefore a comprehensive communication of the vision is 32
crucial. The change agent or change leader must consistently check with staff that they agree with the change and they should be involved in the planning and implementation of the change. Finally it is important that if elements of the change are not working they must be revisited and restructured in order to maximise the success of the change process. Change should not be imposed on people but communicated in a way that they themselves will become leaders of the change project. Chapter 4 Evaluation of the Change Project 4.1 Introduction The evaluation of any change is an important component in the management of change initiatives and a concept that cannot be underestimated. Many people consider evaluation as something that occurs at the end of a project. Oermann and Gaberson (2006) believe that evaluation needs to be viewed as a continuous process and used as a tool to develop organisational efficiencies. The process of evaluation depends on what you are attempting to evaluate the goal of which is to provide feedback on the impact of the project and to measure improvements. Many evaluation tools can be used to calculate these improvements. The tools used for the purpose of this project were questionnaires and focus groups. These tools established that improvements did occur following implementation of the project and will be discussed in the following section. 33
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 and 34: Group One: Nursing documentation- C
Page 35 and 36: Developing the implementation plan.
Page 37 and 38: Communication As discussed in relat
Page 39: Nevertheless as a change agent and
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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