Department
Nursing
Degree Name
Doctor of Nursing Practice (DNP)
Abstract
Inefficient referral processes in community mental health clinics contribute to delayed access to care, fragmented communication, and increased administrative burden. Traditional referral methods, including phone, fax, and paper-based systems, often result in prolonged wait times and documentation errors, negatively impacting patient outcomes. Evidence supports electronic referral (e-referral) systems as effective tools for improving care coordination, reducing delays, and enhancing provider satisfaction. This Doctor of Nursing Practice (DNP) quality improvement project aimed to implement an e-referral system in a community mental health clinic in metropolitan Texas to streamline patient care and reduce referral wait times by at least 30% over a three-month period. Guided by the Plan–Do–Study–Act framework, a pre–post design was used to evaluate outcomes. Pre-intervention data (n = 27) were compared with post-intervention data (n = 53). Descriptive statistics demonstrated a reduction in mean wait time from 11.48 days (SD = 2.67) to 6.77 days (SD = 1.60). An independent samples t-test assuming unequal variances revealed a statistically significant reduction in wait time following implementation, t(35.83) = 8.44, p < .001, with a mean difference of 4.71 days (95% CI [3.58, 5.84]). The effect size was very large (Cohen’s d = 2.33), with excellent statistical power (1.00). Implementation of the e-referral system improved referral efficiency, reduced variability in scheduling, enhanced provider workflow, and strengthened care coordination. Findings support e-referral systems as sustainable, evidence-based strategies to improve access to mental health services and overall healthcare delivery efficiency.
Keywords: referral process, traditional referral, electronic referral, healthcare, quality improvement, communication, community mental health clinic
Keywords
workflow optimization, process improvement, health systems digitization, appointment scheduling efficiency, timely access to care
Advisor
Dr. Jenny Manry
Date of Award
Spring 2026
Document Type
DNP Project
Recommended Citation
NGANTE, JUDITH, "Implementing an Electronic Referral System in a Community Mental Health Clinic to Streamline Patient Care: An Evidence-Based Quality Improvement Project" (2026). Master's Theses or Doctor of Nursing Practice. 3314.
Available at:
https://scholars.fhsu.edu/theses/3314
Rights
© The Author
