Improving the care continuum following discharge from a critical access hospital due to a mental health crisis

Abstract

Data shows that in the first week post-discharge from the hospital following a psychiatric crisis, a person is 300 times more likely than the general population to die by suicide (Chung et al., 2019). Access to outpatient mental health treatment in the week following discharge from the hospital due crisis is an evidence-based intervention measured by the National Committee of Quality Assurance (NCQA) that saves lives. Rural populations have an additional risk of death by suicide due to multiple factors that limit mental health care access. Engaging patients while they are at the hospital with a mental health specialist and scheduling an appointment for outpatient mental health treatment are essential bridges in the mental health care continuum. This DNP project highlights a workflow process in which the hospital peer support specialist communicates with an outpatient mental health clinic crisis care coordinator about patients in need of post-discharge services following a mental health crisis. Through this interdisciplinary process, patients were provided with an outpatient appointment within seven days following hospitalization. The DNP student tracked appointments made for and kept by patients following hospitalization. Although the results were too small for meaningful analysis, lessons learned provide valuable experience for future mental health care coordination quality improvement projects. Limitations include a short six-week implementation timespan and COVID-related influences.