Implementation of Behavioral Emergency Response Team in Triage

Introduction: The aim of this project is to improve the admission process of psychiatric patients in the emergency department (ED) by implementing a Behavioral Emergency Response Team (BERT). The goal is to reduce wait times, decrease patient aggression, and enhance overall patient and staff safety. Background: Emergency departments are experiencing an influx of psychiatric patients presenting with acute psychosis. Long wait times often lead to increased agitation, requiring physical or chemical intervention. Literature suggests that timely care can reduce aggression and psychiatric admissions. Currently, no similar interventions exist at Houston Methodist West Hospital. Methodology: This quality improvement project follows a structured approach to address psychiatric patient boarding in the emergency department. The study is based at Houston Methodist West Emergency Department, where psychiatric patients often experience long wait times, leading to increased agitation. The intervention involves implementing a Behavioral Emergency Response Team (BERT), a multidisciplinary team to respond to triage when psychiatric patients present with acute psychosis. The project is guided by the Plan-Do-Study-Act (PDSA) cycle to ensure an iterative and structured implementation process: Results: Findings suggest that the BERT implementation has contributed to a more streamlined emergency department workflow, improved patient safety, and a reduction in psychiatric distress and aggression. Further analysis will determine long-term sustainability and areas for additional improvement. Implications for Practice: Implementing BERT in triage could significantly improve psychiatric patient management, reduce ED crowding, and enhance patient and staff safety. If successful, this model may serve as a framework for broader hospital adoption.