Anne P F Wand1, Rebecca Wood2, Matthew D Macfarlane3, Glenn E Hunt2. 1. South Eastern Sydney Local Health District, NSW, Australia; Faculty of Medicine, University of New South Wales, NSW, Australia. Electronic address: a.wand@unsw.edu.au. 2. Sydney Local Health District, NSW, Australia; Discipline of Psychiatry, Sydney Medical School, University of Sydney, NSW, Australia. 3. Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia; Graduate School of Medicine, University of Wollongong, Wollongong, NSW, Australia.
Abstract
OBJECTIVE: Consultation-liaison psychiatry (CLP) services vary in terms of structure, function and responsiveness. It is not known whether evaluation measurements can be meaningfully compared across different CLP services to assess value and efficiency. The aim was to develop and test a common tool for measuring process and outcome measures in CLP. METHODS: A data collection tool was developed using the literature and consultation with CLP clinicians. The tool was used to prospectively gather referral data, response times, health utilisation data and functional outcomes for individuals referred over seven months to three different CLP teams, servicing inner city, district and regional areas. RESULTS: The structure, staffing, liaison attachments and scope of practice varied between the services. The regional CLP service attended seven hospitals and had the highest referral rate and largest inpatient population pool. The three services received referrals for similar reasons and made similar diagnoses. Multimodal management was the norm, and CLP facilitated follow-up arrangements upon discharge. Only the district CLP service saw all emergency referrals within an hour. Age and need for an interpreter did not affect response times. CONCLUSION: Despite local differences in geography, CLP roles, hospital and community mental health service pathways and patient populations, the CLP data collection tool was applicable across sites. Staff resourcing and referral demand are key determinants of CLP response times.
OBJECTIVE:Consultation-liaison psychiatry (CLP) services vary in terms of structure, function and responsiveness. It is not known whether evaluation measurements can be meaningfully compared across different CLP services to assess value and efficiency. The aim was to develop and test a common tool for measuring process and outcome measures in CLP. METHODS: A data collection tool was developed using the literature and consultation with CLP clinicians. The tool was used to prospectively gather referral data, response times, health utilisation data and functional outcomes for individuals referred over seven months to three different CLP teams, servicing inner city, district and regional areas. RESULTS: The structure, staffing, liaison attachments and scope of practice varied between the services. The regional CLP service attended seven hospitals and had the highest referral rate and largest inpatient population pool. The three services received referrals for similar reasons and made similar diagnoses. Multimodal management was the norm, and CLP facilitated follow-up arrangements upon discharge. Only the district CLP service saw all emergency referrals within an hour. Age and need for an interpreter did not affect response times. CONCLUSION: Despite local differences in geography, CLP roles, hospital and community mental health service pathways and patient populations, the CLP data collection tool was applicable across sites. Staff resourcing and referral demand are key determinants of CLP response times.
Authors: Allan House; Elspeth Guthrie; Andrew Walker; Jenny Hewsion; Peter Trigwell; Cathy Brennan; Mike Crawford; Carolyn Czoski Murray; Matt Fossey; Claire Hulme; Adam Martin; Alan Quirk; Sandy Tubeuf Journal: BMC Health Serv Res Date: 2018-09-27 Impact factor: 2.655
Authors: Anne M Doherty; Rosie Plunkett; Katherine McEvoy; Eric Kelleher; Maurice Clancy; Elizabeth Barrett; Elaine Greene; Eugene Cassidy; William Lee; Siobhan MacHale Journal: Front Psychiatry Date: 2021-11-29 Impact factor: 4.157