Psychiatric Providers in Triage: Evaluating a Triage-Based Model of Care

ABSTRACTTiana Yadao: Psychiatric Providers in Triage: Evaluating a Triage-Based Model of Care (Under the direction of Lorinda A. Coombs)Aim: This program evaluation assessed the impact of a Psychiatric Provider in Triage (PPIT) model on the timeliness, efficiency, and delivery of psychiatric care in the emergency department (ED). The evaluation examined whether integrating psychiatric providers at triage reduced delays to evaluation, decreased ED length of stay (LOS) for behavioral health patients, and improved care processes in a high-volume clinical setting.Background: Emergency departments nationwide face increasing volumes of patients presenting with mental health crises, often resulting in prolonged waits for psychiatric evaluation and extended ED LOS. Delays in behavioral health care contribute to ED crowding, workflow disruptions, and suboptimal patient experiences. The PPIT model was implemented to address these challenges by embedding psychiatric providers early in the ED workflow.Methods: A mixed-methods, pre–post program evaluation was conducted over three years. Quantitative outcomes from July–September 2023 (pre-implementation) were compared with the same months in 2024 and 2025 following PPIT implementation. Measures included ED LOS, time from registration to psychiatric evaluation, number of daily psychiatric consultations, and daily behavioral health census. Qualitative data were collected via an anonymous electronic survey of ED staff to assess perceptions of workflow, communication, and quality of care.Results: PPIT implementation was associated with significant and sustained improvements in ED throughput for behavioral health patients. Mean ED LOS decreased from 40.2 hours at baseline to 25.3 hours one year post-implementation and 21.7 hours two years post-implementation. Time from registration to psychiatric evaluation declined from approximately 6–7 hours pre-implementation to 2–3 hours post-implementation (p < .001), despite consistently high psychiatric consultation volumes. Modest reductions in daily behavioral health census suggested improved patient flow rather than reduced demand. Survey respondents (n = 53) reported improvements in timely access to psychiatric care, interdisciplinary communication, role clarity, patient flow, and overall quality of care across clinical roles and shifts.Conclusion: Embedding psychiatric providers in ED triage was associated with meaningful improvements in access, efficiency, and care delivery for behavioral health patients. The PPIT model represents a feasible and scalable systems-level strategy to enhance emergency psychiatric care and reduce ED crowding.