Breaking Down Cultural Barriers

The stigma attached to working with patients with emergency psychiatric needs must be carefully examined by hospital administration. It is important that all staff working with this patient population learn to treat them equally and with the same dignity and respect that they would any other ED patient. There are many ways a hospital administrator can create a cultural shift within the hospital system. One possible solution is to create a team of champions comprised of direct care staff, administration, and a patient advocate. This team can work together to create new avenues of process improvement within the ED psychiatric care program. Ideally, passionate and motivated staff should lead this team of champions. This initial burst of energy is required to disseminate new ideas and process changes throughout the hospital system. The difference in approaching current staff and newly hired staff has its own set of differing challenges.

Another foundation that this team of champions can build on is found at the very beginning, when a new employee is onboarded. A carefully thought-out new employee orientation that provides specific cultural examples that fit in with the vision of the organization has proved very successful in our experience. We refer the reader to Chapter 5 on care options, treatment teams, and operational improvement for further details. Consider using elements from these chapters for your new employee orientation, as well as ongoing cultural-change workshops.

We have experience creating a team of champions. We were pleasantly surprised to find many people asking to join the team. The patient-centric changes we implemented resonated with the staff. We found that nurses and even ED MDs with minimal to no interest in specifically working with psychiatric patients changed their minds and became the newest advocates for culturally appropriate care. When the “why” of the vision was discussed and was “metabolized,” we saw many barriers overcome.

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