How the emergency department four-hour target affects clinical outcomes for patients diagnosed with a personality disorder

MICHAEL HASLAM

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Abstract

Emergency departments (EDs) may already be invalidating environments for patients diagnosed with a personality disorder, with negative attitudes from staff perpetuating patients’ feelings of dismissal and rejection. Despite a higher prevalence of patients with personality disorder in health services, including EDs, than the general population, there is a lack of literature on how achieving ED targets may affect this patient group.

This article expands on Harden’s concept of destructive goal pursuit in relation to the four-hour target and uses the literature to illustrate how pressures to meet the target may distort clinical priorities and result in adverse clinical outcomes for patients. It makes recommendations for practice including using short-stay units in which patients can be treated outside of the target wait time and introducing mental health triage in EDs to improve delivery of psychosocial assessments.
Original languageEnglish
Article number1
Pages (from-to)20-24
Number of pages5
JournalEmergency Nurse
Volume27
Issue number4
Early online date28 May 2019
DOIs
Publication statusPublished - 1 Jul 2019

Keywords

  • Emergency department
  • Mental health
  • Outcomes measures
  • Patient experience
  • Patient outcomes
  • Patients
  • Personality disorder

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