ABSTRACT
While the list of barriers may appear daunting, cultural and historical barriers that impact hospital administrators and their team need to be researched, clearly understood, and overcome in order to make real change. Historically, inpatient psychiatric hospitalization was the standard and often only treatment option for patients requiring moderate to severe psychiatric care. The emergency department (ED) psychiatric team must act as an outspoken advocate for their patients, and must move out of their comfort zone and push for increased resources for these vulnerable patients. John Kotter, the illustrious author, has created one elegant model for change management that fits well within the context of psychiatry. He created a defined eight-step process that fits well into the model for change. They are: establish a sense of urgency, form a powerful coalition, create a vision, communicating the vision, empower others to act on the vision, plan for and create short-term wins, consolidate improvements and produce more change, and institutionalize new approaches.
