The impact of a flow strategy for patients who presented to an Australian emergency department with a mental health illness

• Almost 40% of patients diagnosed with mental health illness were admitted from ED.
• A new model of care to improve patient flow from ED was implemented.
• The proportion of patients admitted or discharged from ED within 4 hours increased.
• Time spent waiting to see a medical officer did not change significantly.
• Improvements in service delivery can be realised without additional staffing.

ObjectivesTo describe and compare characteristics, care delivered, and outcomes of patients who presented to an emergency department (ED) with a mental health illness before and after the implementation of a patient flow strategy.MethodsThis was a retrospective, descriptive study. Health care data of patients who presented to a public teaching hospital ED in Queensland, Australia diagnosed with a mental health illness before (5th September 2011–4th March 2012) and after (5th March 2012–4th September 2012) the implementation of a patient flow strategy were analysed.ResultsA total of 3037 (before: n = 1511; after: n = 1526) mental health presentations (4.5% of all ED presentations) were made to the ED. Following the implementation of a patient flow strategy, improvements in ED length of stay, tests performed and nursing observations were seen. These varied by mental health diagnosis.ConclusionOur results indicate that a targeted approach to improving service delivery for a specific cohort of ED patients can make a difference without additional staffing. Further focused refinement of the strategy (such as time waiting for treatment) may be required.