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

The observational audit carried out in triage pre the implementation noted that
patients triaged using the Mental Illness Triage Tool were given a higher triage category
(Appendix Q) than those triaged using the Manchester Triage Scale. Finally triage times were
reduced from six minutes to four minutes. This reduction according to staff was related to the
computerised pop-up screen
While staff almost unanimously agreed that the computerised pop-up screen and the
triage tool were of benefit to the department, the nursing assessment document was not
greeted with the same level of enthusiasm. The design was not the issue; the fact was that
nursing staff considered that there were too many nursing documents to manage. It was
suggested that the design should be amalgamated with the original document.
Despite not accomplishing all the elements outlined in the Project Impact statement it
was considered that the change management project was ultimately a success. Those
elements not achieved are currently being considered by management (such as the contacting
of psychiatry direct from triage and the retention of a mental health nurse practitioner) and
negotiations are in progress with the relevant authorities.
4.3 Conclusion
The results of the questionnaires, focus group and interviews have provided
considerable information on the benefits of the change project. Based on the findings it can
be concluded that; the use of a well structured triage tool can benefit the assessment of the
patient and significantly increase staff confidence by providing guidance in relation to the
patient’s presentation. The development of a triage screen that requires only a “yes” or “no”
response while still gathering significant information on the patient helps to cut down on
triage times. These initiatives have led to improvements for patients and staff highlighting
that although a project may be small it can have huge implications and benefits.
The next chapter discusses the strengths and limitations of the project and also
recommendations for the future.
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