• mental health promotion;
  • nurse practitioner;
  • primary care;
  • realistic evaluation

Refining the model for an emergency department-based mental health nurse practitioner outpatient service

The mental health nurse practitioner (MHNP) role based in the emergency department (ED) has emerged in response to an increase in mental health-related presentations and subsequent concerns over waiting times, co-ordination of care and therapeutic intervention. The MHNP role also provides scope for the delivery of specialised primary care. Nursing authors are reporting on nurse-led outpatient clinics as a method of healthcare delivery that allows for enhanced access to health-care, particularly following hospital discharge. However, due to a lack of in-depth substantiation, this mode of service delivery requires more thorough investigation. This study describes the refinement phase undertaken before the implementation and pilot evaluation of a formalised and structured MHNP outpatient service in the ED of a large inner-city hospital in Sydney, Australia. An expert advisory panel (EAP) consisting of key local informants was convened to provide feedback on and refinement to the proposed model. This related to issues such as target population, structure and process considerations, outcome measures and interface within the overall health service. Findings from the EAP meeting are presented and discussed. The importance of linking methods with the appropriate methodology in evaluating a healthcare program is highlighted.