Texting as a Means of Reducing Pediatric Adolescent Psychiatric Emergency Encounters Wait Times.

RATIONALE: There is no universal system to facilitate communication between emergency rooms (ERs) and pediatric mental health providers, which leads to long wait times. This project tested the concept that a group texting application (GroupMe) could improve communication between providers and could reduce wait times by allowing frontline workers to contact multiple providers simultaneously. METHODS: We compared total wait times or overall length of service of 906 ER encounters before and 921 encounters after the GroupMe texting application was implemented. To reduce differences between preintervention and postintervention time points, we utilized propensity score matching to generate a matched group of controls (total sample n = 831 ER encounters before and n = 831 ER encounters after). RESULTS: Although there were no differences in total wait times when using the GroupMe application, there was a significant decrease in wait times after patients were diagnosed in ER by psychiatric provider both before (mean difference, 96.4 minutes saved; t = 2.23; P < 0.05) and after propensity score matching (mean difference, 88.0 minutes saved; t = 2.48; P < 0.05) for disposition type and acuity level. CONCLUSIONS: Use of a group texting application has the potential to improve communication and wait times. However, its ability to reduce overall wait times is hampered when the limited availability of pediatric psychiatry providers results in delays in diagnosis and treatment decisions.

Finding the leader within: thoughts on leadership in nursing.

Leadership is an important topic in nursing. We recognize the importance of leaders who represent us well to those outside of the profession, yet many nurses do not view themselves as "leaders." This is unfortunate, because real leadership is less about a title or institutionally granted power, and more about how we "show up" in the many situations that make up our days. The image of the nursing profession is formed in the many day-to-day interactions between nurses and patients, families, the public, physicians, and administrators. Nurses who can find their inner leader and use it in their practice, at whatever level of the organization they contribute, will find that they are able to positively impact patient care and outcomes. This paper describes a framework for finding your inner leader that is based upon 5 "skill-cepts" (skills derived from leadership concepts), which we have found essential to leading.

A model of nursing care microsystems for a large neonatal intensive care unit.

Nationally the number and size of neonatal intensive care units (NICUs) continues to grow. Today, NICUs with >40 beds, often referred to as "megaunits," are not uncommon. Staff in large units find it challenging to maintain teamwork, communication, and continuity of nursing care for patients. Families find large units overwhelming. In large NICUs, nurse leaders struggle to achieve a balance between parent satisfaction with care provided and nursing job satisfaction. This article describes the development of a new model of nursing practice, a nursing team microsystem. This innovative model has the unique effect of creating smaller units within the larger one, using highly skilled nursing teams, that are geographically grouped to provide care for infants and their families. The model supports teamwork, communication, continuity of care, and has shown a positive impact on both family and nurses' job satisfaction.