Date Approved


Graduate Degree Type


Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Dr. Dianne Slager

Second Advisor

Dr. Donna Rinker

Academic Year



Background: Three Midwest rural community hospital emergency departments’ existing guidelines for behavioral health patients are not meeting the organization’s needs.

Objective: To perform gap analyses of three Midwest rural community hospitals’ emergency departments followed by the development of a behavioral health resource toolkit to improve care and reduce length of stay for behavioral health patients.

Methods: The project included an organizational assessment, literature review, and performance gap analyses of three rural community hospital emergency departments. Specific unidentifiable cohort data was gathered from October 2021 to December 2021. The data outcomes were used to provide vital information for the organization and assisted in the development of the toolkit.

Results: The gap analyses of the three rural community hospitals’ emergency departments found that behavioral health patients waiting for an inpatient behavioral health bed had an average length of stay of 29 to 32 hours, while behavioral health patients discharged home experienced an average length of stay of four to eight hours.

Conclusions: The gap analyses findings demonstrated a need for the organization to develop a behavioral health resource toolkit. A toolkit will provide emergency department staff with resources to guide care for behavioral health patients experiencing long lengths of stay.

Keywords: Behavioral health toolkit, gap analyses, emergency department length of stay, quality improvement.

Available for download on Monday, April 28, 2025