TABLE 3.

Themes From the Hospital Staff Interviews

Theme and Supporting Quotes
Organization and Meshing of Professional Cultures
• [In reference to therapy groups] “Our patients felt that the Bellevue patients were getting something that they weren’t getting, and I was trying to make them realize that this wasn’t the case….Some of the Bellevue clients had a chance to open up, and realized that there really was no difference.”
• [In reference to Bellevue staff arriving at Metropolitan] “Initially, because they didn’t have any of their resources and we had ours, there was some resentment because we had to do our work, while they had it easy while we were under duress because of them.”
• [In reference to Metropolitan staff hosting Bellevue staff] “They helped us get what we needed, tried to make sure everything was taken care of, and we didn’t have keys, so they were helping us out and really going above and beyond.”
Navigating Regulation
• “Our experience with [the regulatory agencies] was that they were very supportive and helpful, with respect to letting us relax certain regulations, in order to make it more effective and efficient for patients, and they really followed our lead, whatever we asked them for, they were really pretty reasonable and responsive.”
• “It was difficult working with Bellevue patients since we have some rules here that they don’t implement there, which makes it difficult since we have to explain to every client of Bellevue that this is what we do here. Some understood, some complained ‘Well at Bellevue, we didn’t have to do this.’”
• “We were able to get things like emergency accreditation for all the doctors, which included a fast track to IT stuff we needed; they had us up and running with accounts within a day.”
Communication
• “One of the hardest things was not knowing if or when we would go back, and the lack of communication from [central office] or Bellevue made it hard to keep staff morale up.”
• “Staff wasn’t aware that [Bellevue was] coming. That was the problem; there was no communication in the beginning, patients just showed up.”
• “[The biggest problem was] lack of communication in general. City agencies not communicating with each other, people at Bellevue and Metropolitan not communicating well in the beginning, because you can make a lot of things better with good communication, and really mess things up with bad communication.”
• “Fortunately, after everything was over and [the other programs] called us to see if we had medicated their clients, they told us the true dose, and everyone had told the truth except for one patient which was off by 10 mg.”
Accommodations
For Patients
• “We had our medication nurse on one side, and eventually opened up another station on the other side. The great thing about that was it allowed the Bellevue nurses to stand on one side and our nurses on the other. We managed to get the other station open, it was very helpful.”
• “[The doctor] helped us get coffee for our patients, asked what we needed, and these little things went a long way”
Psychiatric Services for Staff
• “What we did was start asking food service to bring up coffee and snacks. Another thing was to quickly arrange schedules of additional group counseling, and arrange space for counselors from Bellevue who were asked to come on board. Most of the other services were also asked to come here. We doubled up on counseling services.”