Performance measurement tools for consultation-liaison psychiatry services must consider feasibility

Kroll, David S.; Gopal, Arun; Kimmel, Ryan J.; Mattson, Janice; Beizai, Kristin; Danovitch, Itai

doi:10.1016/j.genhosppsych.2020.02.002

Cited by 3 publications

(4 citation statements)

References 26 publications

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“…Many psychiatry departments continue to struggle with how to define and measure the impact of their services in hospital systems. 12 The identification of recurring problems that both resonate across systems and can potentially be linked to the effectiveness of psychiatric care even when it is primarily consultative in nature-for example, suicide, violence, and premature discharges-may help to inform these efforts.…”

Section: Discussionmentioning

confidence: 99%

“…Understanding the kinds of safety events that arise in the context of psychiatric care can help psychiatry departments identify potential targets for quality measurement and quality improvement. Many psychiatry departments continue to struggle with how to define and measure the impact of their services in hospital systems 12 . The identification of recurring problems that both resonate across systems and can potentially be linked to the effectiveness of psychiatric care even when it is primarily consultative in nature—for example, suicide, violence, and premature discharges—may help to inform these efforts.…”

Section: Discussionmentioning

confidence: 99%

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Anticipating Patient Safety Events in Psychiatric Care

YERSTEIN,

SUNDARARAJ,

MCLEAN

et al. 2024

Journal of Psychiatric Practice

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Objectives: Although suicide prevention often dominates patient safety efforts in psychiatry and behavioral health, patients who seek such services are also prone to other kinds of adverse events. The purpose of this study was to more fully characterize the types of safety events that occur in the context of psychiatric care. Methods: This was a retrospective study of safety events that had been reported to a hospital-based psychiatry department during a 4-year period. The authors reviewed each incident, developed new and more precise event categories, and assigned each report to a category. Events that could not be categorized were assigned to an “Other” category. The percentages of categorizable events between the new and old frameworks were compared. Results: A total of 366 reports were filed. In the updated framework, 324 events (89%) could be categorized compared to 225 (61%) in the original registry. Conclusions: Understanding the kinds of safety events that clinicians are likely to encounter in the context of psychiatric care may help to expand patient safety efforts beyond suicide risk prevention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anticipating Patient Safety Events in Psychiatric Care

YERSTEIN,

SUNDARARAJ,

MCLEAN

et al. 2024

Journal of Psychiatric Practice

Self Cite

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“…There is a clear need for robust data to be routinely collected in order to identify the areas where there is greatest need as well as simply quantifying activity. This is a challenge internationally ( 32 ). Such data would allow for the activity-based commissioning of services and would lead the way toward ensuring that services are adequately resourced for the needs of their patients.…”

Section: Limitationsmentioning

confidence: 99%

Consultation-Liaison Psychiatry Services in Ireland: A National Cross-Sectional Study

et al. 2021

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Objective: This study aimed to describe the provision of consultation-liaison psychiatry (CLP, also known as liaison psychiatry) services in acute hospitals in Ireland, and to measure it against recommended resourcing levels.Methods: This is a survey of all acute hospitals in Ireland with Emergency Departments, via an electronic survey sent by email and followed up by telephone calls for missing data. Data were collected on service configuration, activity, and resourcing. Data were collected from CLP or proxy services at all acute hospitals with an Emergency Department in Ireland (n = 29). This study measured staffing and activity levels where available.Results: None of the services met the minimum criteria set out by either national or international guidance per 500 bed general hospital.Conclusions: CLP is a relatively new specialty in Ireland, but there are clear international guidelines about the staffing levels required to run these services safely and effectively. In Ireland, despite clear national guidance on staffing levels, no services are staffed to the levels suggested as the minimum. It is likely that patients in Ireland's acute hospitals have worse outcomes, and hospitals have unnecessary costs, due to this lack. This is the first study of CLP provision in Ireland and demonstrates the resource constraints under which most services work and the heterogeneity of services nationally.

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“…Some of the more recent international studies in this area have focussed on the positive impact of liaison psychiatry on reductions in length of stay (Vulser et al , 2019; Oldham et al , 2019; House et al , 2020), improvements in the emergency department waiting for times (Evans et al , 2019) and overall cost savings benefits (Okoronkwo, 2019). However, there is little consistency in measurement and wide variability in the quality of research design, with a number of authors calling for routine and systematic measurement (Trigwell et al , 2015; Fossey and Parsonage, 2014; Kroll et al , 2020).…”

Section: Introductionmentioning

confidence: 99%

Understanding liaison psychiatry commissioning: an observational study

Fossey

Godier-McBard

Guthrie

et al. 2020

MHRJ

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Purpose The purpose of this paper is to explore the challenges that are experienced by staff responsible for commissioning liaison psychiatry services and to establish if these are shared by other health professionals. Design/methodology/approach Using a mixed-methods design, the findings from a mental health commissioner workshop (n = 12) were used to construct a survey that was distributed to health care professionals using an opportunistic framework (n = 98). Findings Four key themes emerged from the workshop, which was tested using the survey. The importance of secure funding; a better understanding of health care systems and pathways; partnership working and co-production and; access to mental health clinical information in general hospitals. There was broad convergence between commissioners, mental health clinicians and managers, except in relation to gathering and sharing of data. This suggests that poor communication between professionals is of concern. Research limitations/implications There were a small number of survey respondents (n = 98). The sampling used an opportunistic framework that targeted commissioner and clinician forums. Using an opportunistic framework, the sample may not be representative. Additionally, multiple pairwise comparisons were conducted during the analysis of the survey responses, increasing the risk that significant results were found by chance. Practical implications A number of steps were identified that could be applied in practice. These mainly related to the importance of collecting and communicating data and co-production with commissioners in the design, development and monitoring of liaison psychiatry services. Originality/value This is the first study that has specifically considered the challenges associated with the commissioning of liaison psychiatry services.

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Performance measurement tools for consultation-liaison psychiatry services must consider feasibility

Cited by 3 publications

References 26 publications

Anticipating Patient Safety Events in Psychiatric Care

Anticipating Patient Safety Events in Psychiatric Care

Consultation-Liaison Psychiatry Services in Ireland: A National Cross-Sectional Study

Understanding liaison psychiatry commissioning: an observational study

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