Transport Investments, Livability and Mental Health: Setting a Baseline for a Green Corridor in Cali, Colombia

Objective The aim of the paper was to describe a suite of capacity management principles that have been applied in the mental health setting that resulted in a significant reduction in time spent in two emergency departments (ED) and improved throughput. Methods The project consisted of a multifocal change approach over three phases that included: (1) the implementation of a suite of fundamental capacity management activities led by the service and clinical director; (2) a targeted Winter Demand Plan supported by McKinsey and Co.; and (3) a sustainability of change phase. Descriptive statistics was used to analyse the performance data that was collected through-out the project. Results This capacity management project has resulted in sustained patient flow improvement. There was a reduction in the average length of stay (LOS) in the ED for consumers with mental health presentations to the ED. At the commencement of the project, in July 2014, the average LOS was 20.5 h compared with 8.5 h in December 2015 post the sustainability phase. In July 2014, the percentage of consumers staying longer than 24 h was 26% (n = 112); in November and December 2015, this had reduced to 6% and 7 5% respectively (less than one consumer per day). Conclusion Improving patient flow is multifactorial. Increased attendances in public EDs by people with mental health problems and the lengthening boarding in the ED affect the overall ED throughput. Key strategies to improve mental health consumer flow need to focus on engagement, leadership, embedding fundamentals, managing and target setting. What is known about the topic? Improving patient flow in the acute sector is an emerging topic in the health literature in response to increasing pressures of access block in EDs. What does this paper add? This paper describes the application of a suite of patient flow improvement principles that were applied in the mental health setting that significantly reduced the waiting time for consumers in two EDs. What are the implications for practitioners? No single improvement will reduce access block in the ED for mental health consumers. Reductions in waiting times require a concerted, multifocal approach across all components of the acute mental health journey.

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The Effects of Different Natural Environment Influences on Health and Psychological Well-Being of People: A Case Study in Selangor

Sustainability ◽

10.3390/su13158597 ◽

2021 ◽

Vol 13 (15) ◽

pp. 8597

Author(s):

Thivya Laxshmy Raman ◽

Nor Akmar Abdul Aziz ◽

Sam Shor Nahar Yaakob

Keyword(s):

Mental Health ◽

Stress Reduction ◽

Urban Forest ◽

Well Being ◽

Natural Environments ◽

Restorative Environments ◽

Urban Green ◽

Recreational Services ◽

Forested Areas ◽

Green Corridor

Background: People benefit from the recreational services provided by an urban corridor, urban park, and urban forest. Due to ongoing land-use interest and urban development, however, these natural environments are coming under increasing pressure. Simultaneously, the world is becoming increasingly urbanised, and living in cities has been linked to mental health issues. On the other hand, different natural environments are known to create healthier environments, and the need for effective restorative environments has never been greater. The purpose of the study was to compare the impacts of walking in different natural environments. Methods: I) Kota Damansara Community Forest Reserve, II) Mutiara Damansara Recreational Park, and III) the Urban Green Corridor along Jalan PJU 7/7 were used as control study sites in this study. Each site was visited only once by the study participants (40 women and 40 men). Walking for 30 min was a part of the experiment. To identify the psychological effects of different natural environments, the Depression, Anxiety, and Stress Scale (DASS21), Profile of Mood States (POMS), Positive and Negative Affect Schedule (PANAS), and Restoration Outcome Scale (ROS) were utilised. Results: In all three natural environments, the restorative effects were found to increase significantly. Conclusion: The overall conclusion of the field experiment is that being in an urban green corridor can also provide a refreshing environment. In terms of stress reduction among working adults, the recreational park is sufficient, while urban-forested areas are more effective in improving mental health by minimising stress, anxiety, and depression.

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