| Learning Objective #1: Improve scientific understanding of the process and issues involved in providing care to psychiatric patients in the general hospital emergency department | |||
| Learning Objective #2: Identify climate-related variables examined in the research model |
The number of acutely ill psychiatric patients that seek care in general hospital emergency departments has grown tremendously recently. This poses problems for both psychiatric workers and ED health care givers. This study was designed to improve scientific understanding of the process and issues involved in providing care to psychiatric patients in the ED.
This study utilized both qualitative and quantitative methodologies to examine these complex processes and dynamics. The core set of data are systematic observations gathered by the research team as well as reports of the short survey tool distributed to the ED and psychiatric staffs. The survey tool was an adaptation of Glisson’s tool to measure organizational climate.
The survey instrument included scales designed to measure staff members perceptions of their work environment, attitudes toward mental illness and it’s treatment, staff’s comfort with clinical work with psychiatric patients in the ED, and select demographic characteristics. 131 useable surveys were returned yielding a 67.9% response rate. Data were analyzed using multivariate statistics and showed that staff members subjective understanding of the needs of patients with mental health problems are shaped by organizational climate and their individual-level mental health experiences and attitudes. Their perceptions of the fairness and equity of their work environment (b=27, P< .05) is associated with higher level of understanding while feelings of work role ambiguity is correlated with lower levels of understanding. Role ambiguity was the most important organizational climate-related variable in the model. Nurses seemed to bear the bulk of responsibility of care for these patients and observational data showed a poor fit between what psychiatric patients need and want and what general ED staff are able and expected to provide. A final conclusion showed that the organizational context of health care settings can impact the quality of care provided by health care professionals.
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