Reducing length of stay in the emergency department for patients with mental health conditions: a service evaluation.

Abstract

People with mental health conditions frequently experience prolonged stays in the emergency department (ED) while awaiting specialist care or an inpatient bed. This article reports the findings of a service evaluation that explored the effectiveness of a daily 'huddle' between ED staff and the liaison psychiatric service (LPS) team in one ED in England in reducing length of stay for this patient population. The evaluation used a convergent mixed-methods design involving the collection and analysis of quantitative data on four key performance indicators (KPIs) (overall length of stay, time to psychiatric assessment, time to psychiatric referral and time to medical assessment) and qualitative data from a focus group discussion with staff. The findings suggest that ED staff should be provided with comprehensive training, including on de-escalation techniques and on recognising and understanding mental health issues, and that a cultural shift is required within EDs to achieve parity of esteem between mental health and physical health.