Capacity and Capability

This page will support teams in assessing their capacity and capability and evaluating their program's readiness to expand into the emergency department (ED) setting.

Definitions:

Capacity  is a measure of the amount of work an organization can do. It's based on its current infrastructure. It's measured in terms of the number of resources or staff members that are available to address the need (e.g., is your team currently at its capacity or could it take on more work?).

Capability  is your organization's ability to achieve specific outcomes or objectives. An organization needs a combination of people, processes, and technology to perform a task or function. It measures the level of ability (e.g., skills, knowledge, resources) your team has to meet the need.

Building Your Team’s Capacity and Capability for ED Expansion Work

As you look at your team’s ability to expand into the ED, understanding the expertise you have and the services you offer, or what you are capable of offering, will largely dictate the work path you choose. Setting yourself up for success means being realistic about your team’s ability to work with ED providers. You should establish those expectations early on.

Establishing Your Key Team Members

As you assess your team, we found that the below were essential members of ED expansion work:

  • Clinical Lead/Medical Director
  • Program Manager/Administration
  • Project Manager or Coordinator
  • Social Worker/Licensed Mental Health Worker
  • Child Psychiatrist
  • Data Manager
  • Community Resource Coordinator (e.g., community health worker)
  • Legal Counsel
  • IT Support

Internal Assessment for Teams

To effectively prepare your team for ED work, you need to answer several important questions. These questions will determine your team's ability to meet the needs of the EDs you plan to work with. This will help set realistic expectations for your team's ED expansion work.

Here are some important questions to consider to determine your team's capacity and capability:

Team Activity   Pro-Tips   The 4 S's of Capacity and Capability  

Begin by answering the following questions:

  • Who is on your team and what are their roles?
    • Do you utilize trainees or residents?
    • Who is managing your data?
  • Who are you directing your services to?
    • Are you targeting physicians? Nurses? Staff?
  • What are you offering?
    • Education on appropriate screening to providers?
    • Provider-to-provider consultation on medical management best practices?
    • Discharge coordination to help link patients to resources in the community?
    • Other?
  • When are you available to ED providers?
    • 24/7 or standard work-week schedule?
    • Do you have the ability to offer late-night or weekend shifts for providers?
  • Where will you be providing this service?
    • Do you have any team members located in the ED?
    • Is your team fully remote?
  • Why is your program's service of value?
    • Are you able to demonstrate an impact on psychiatric boarding?
    • How can you measure your program’s impact on the ED?
    • Do you have data to support your program’s work when you approach EDs?
  • How will you offer your services to providers in the ED?
    • Do you go in person to deliver your services?
    • Do you leverage any technologies to connect with providers?
    • Have you explored the use of telehealth platforms (beyond telephone) in reaching more providers?
  • How are you leveraging other groups or community organizations/services to expand your capacity?
    • Have you explored the possibility of reaching out to clinical programs or professional organizations to acquire more personnel and expertise to benefit your project?
  • Expanding your Capacity
    • If you work with an academic institution or medical center, consider leveraging other groups such as state boards of social work, counseling and psychology, graduate schools, and mental health trainee programs.
    • Technology may also be considered in enhancing your capacity by automating certain processes that you are doing manually. It may also allow you to provide asynchronous education and training opportunities, allowing your team to reach more without having to be there in real time.
  • Connections to the Community
    • As an acute-care institution, EDs are not equipped to manage a patient's care over time. Consequently, patients are not tracked or followed up with after discharge. ED providers may not be aware of the resources available to connect patients to or know which resources are accepting new patients. We have discovered that having a coordinator to assist providers in connecting patients to appropriate and timely community resources has proved valuable to many EDs. As your team expands, consider including this role as one of the team members..
  • Explore Additional ED Education and Training for Team Members
    • EIIC offers tools, resources, and educational opportunities to PMHCAs. They want to learn more about the ED and its inner workings. We offer toolkits, recorded webinars, and 1:1 technical assistance to PMHCA teams in need of help.
  • Stuff: What are the tools and resources you have available to you?
  • Staff: What does your current staffing and personnel situation look like?
  • Space: What spaces you are working within?
  • Systems: What policies and procedures are in place guiding your work?
For helpful links to resources, visit our PMHCA Resource Library!