title: Replacing revolving door: a collaborative approach to treating individuals in crisis.
abstract: The Crisis Assessment and Psychiatric Emergency Services (CAPES) unit was designed to improve the quality of psychiatric treatment, contain costs, and provide relief to overburdened psychiatric inpatient and emergency services in Delaware. This innovative program is the result of collaboration between public and private agencies to treat individuals in crisis. The myriad factors that contributed to a broken system and instigated Delaware's search for a solution are discussed in this article. The CAPES unit has resulted in improved communication among providers, decreased committal rates, better linkage to appropriate levels of care, increased safety, and improved coordination of services. Clinical implications for nursing practice include providing more holistic care in a safer environment.
authors.affiliation: Christiana Care Health System, Wilmington, DE 19809, USA. mlauer@christianacare.org
authors.forename: Michelle
authors.initials: M
authors.lastname: Lauer
authors.forename: Rose
authors.initials: R
authors.lastname: Brownstein
mesh_terms: D000328:Adult; D003142:Communication; D003266:Continuity of Patient Care; D003299:Cooperative Behavior; D003363:Cost Control; D003419:Crisis Intervention / Q000458:organization & administration*; D003691:Delaware; D004637:Emergency Services, Psychiatric / Q000458:organization & administration*; D006757:Hospital Units / Q000458:organization & administration; D006801:Humans; D007326:Institutionalization; D007373:Interinstitutional Relations; D007374:Interior Design and Furnishings; D008297:Male; D017146:Models, Organizational; D009730:Nursing Assessment; D010359:Patient Readmission; D017149:Private Sector / Q000458:organization & administration; D016730:Program Development; D015397:Program Evaluation; D011568:Psychiatric Nursing / Q000458:organization & administration*; D017150:Public Sector / Q000458:organization & administration; D017749:Total Quality Management / Q000458:organization & administration