Impact of an integrated rapid response psychiatric liaison team on quality improvement and cost savings: the Birmingham RAID model

Abstract

Aims and methodTo evaluate whether the implementation of the Rapid Assessment, Interface and Discharge (RAID) integrated model improves access to psychiatric assessment and reduces cost of health service provision in an acute hospital. Length of hospital stay was calculated using a case-by-case matched control design. Readmission rates were calculated and survival analysis was used to measure endurance in the community following discharge.ResultsIn an acute hospital with 600 beds, the total savings in bed days through reducing length of stay and readmissions was 43–64 beds per day. The elderly care wards provided the majority of bed savings.Clinical implicationsThe development of a rapid response, age-inclusive, comprehensive psychiatric team integrated in an acute hospital can lead to significant savings in health service provision.

Comorbidity and dementia: a scoping review of the literature

“…A number of initiatives have been developed to improve the care of older people with dementia in acute hospitals, including liaison psychiatric services [50,73] or specialist units that combine medical and mental health care for older people [41,44]. Much of the work in this area is AMD, age-related macular degeneration; AMI, acute myocardial infarction; CI, cognitive impairment; DM, diabetes mellitus; HbA1c, glycosylated hemoglobin; LDL-C, low-density lipoprotein cholesterol PWD, people with dementia; QOF, quality of life; VEGF, vascular endothelial growth factor; VI, visual impairment.…”

A solution to the ossification of community psychiatry

“…23,24 In this model, all elements of good liaison and community care can be combined and deployed when needed, and the clinicians in the services also have a more satisfying working relationship with patients with a greater degree of variety than at present. This does not mean that specialist teams are unnecessary, particularly for some in-patients such as those in longer-term rehabilitation, and for other disorders 25,26 where there is much room for improvement, but for acute care an integrated system makes better use of expertise and brings community and hospital services together.…”

Prescribing by mental health nurses in acute general hospitals

“…The RAID model began in December 2009 aiming to deliver mental health services to Birmingham City Hospital acute hospital 7 days per week, 24 hours per day; the aim being to assess individual's mental health. RAID works within the emergency department and inpatient acute wards (Tadros et al 2013). Tadros et al (2013) demonstrated that the main types of referrals to mental health services from acute hospitals for assessment of mental health and associated risks included; Foley (2013) identified that the RAID model has been instrumental in showing the cost benefits for a mental health service in the acute hospital, suggesting that for every £1 invested in MHLTs £4 is saved.…”

“…RAID works within the emergency department and inpatient acute wards (Tadros et al 2013). Tadros et al (2013) demonstrated that the main types of referrals to mental health services from acute hospitals for assessment of mental health and associated risks included; Foley (2013) identified that the RAID model has been instrumental in showing the cost benefits for a mental health service in the acute hospital, suggesting that for every £1 invested in MHLTs £4 is saved. Parsonage and Fosey (2011) concluded that the RAID model can save up to £9.5 million per year for the acute hospital, though savings would depend on different sizes of the acute hospitals and the MHLTs commissioned to deliver such a service.…”

“…Therefore there can be an inference that MHN NMPs working within acute environments add value to patient care and the multidisciplinary team. There are numerous articles and research based on MHLTs and their positive impact on the acute environment (Baldwin 2004, Wand & Fisher 2006, Tadros 2013 ).…”