A systematic review of proactive psychiatric consultation on hospital length of stay

Oldham, Mark; Chahal, Khushminder; Lee, Ho-Chang

doi:10.1016/j.genhosppsych.2019.08.001

Cited by 54 publications

(32 citation statements)

References 31 publications

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“…Research has confirmed how effective CLP clinical actions may help improving outcome indicators of health care, i.e., long-term prognosis of medical conditions, adherence to care plans, quality of life and disability of patients, length of hospital stay, health direct and indirect costs [ 7 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Is Consultation-Liaison Psychiatry ‘Getting Old’? How Psychiatry Referrals in the General Hospital Have Changed over 20 Years

Ferrari

Mattei

Marchi

et al. 2020

IJERPH

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There is an ever-growing awareness of the health-related special needs of older patients, and Consultation-Liaison Psychiatry Services (CLPS) are significantly involved in providing such age-friendly hospital care. CLPS perform psychiatric assessment for hospitalized patients with suspected medical-psychiatric comorbidity and support ward teams in a bio-psycho-social oriented care management. Changes in features of the population referred to a CLPS over a 20-year course were analysed and discussed, especially comparing older and younger referred subjects. Epidemiological and clinical data from all first psychiatric consultations carried out at the Modena (North of Italy) University Hospital CLPS in the period 2000–2019 (N = 19,278) were included; two groups of consultations were created according to the age of patients: OV65 (consultations for patients older than 64 years) and NONOV65 (all the rest of consultations). Consultations for OV65 were about 38.9% of the total assessments performed, with an average of approximately 375 per year, vs. the 589 performed for NOV65. The number of referrals for older patients significantly increased over the 20 years. The mean age and the male/female ratio of the sample changed significantly across the years in the whole sample as well as both among OV65 and NOV65. Urgent referrals were more frequent among NOV65 and the rate between urgent/non urgent referrals changed differently in the two subgroups. The analysis outlined recurring patterns that should guide future clinical, training and research activities.

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Section: Introductionmentioning

confidence: 99%

Is Consultation-Liaison Psychiatry ‘Getting Old’? How Psychiatry Referrals in the General Hospital Have Changed over 20 Years

Ferrari

Mattei

Marchi

et al. 2020

IJERPH

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“…Additionally, proactive consultation liaison psychiatry (i.e., psychiatrists working in medical or surgical hospital settings or multidisciplinary team-based models) with clinically informed screening and integrated care delivery reduce length of stay in general hospital settings We computed a score for AMSTAR 2 by scoring all items whose criteria were fully fulfilled by a study as "1" and all other items as "0" and by transforming the raw scores into percentage of maximum possible scores (POMP scores [18]). 8 W. Gaebel et al [34]. Consultation liaison psychiatry should be implemented in both inpatient and outpatient medical healthcare.…”

Section: Crisis Intervention Servicesmentioning

confidence: 99%

EPA guidance on the quality of mental health services: A systematic meta-review and update of recommendations focusing on care coordination

et al. 2020

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Background. The quality of mental health services is crucial for the effectiveness and efficiency of mental healthcare systems, symptom reduction, and quality of life improvements in persons with mental illness. In recent years, particularly care coordination (i.e., the integration of care across different providers and treatment settings) has received increased attention and has been put into practice. Thus, we focused on care coordination in this update of a previous European Psychiatric Association (EPA) guidance on the quality of mental health services. Methods. We conducted a systematic meta-review of systematic reviews, meta-analyses, and evidence-based clinical guidelines focusing on care coordination for persons with mental illness in three literature databases. Results. We identified 23 relevant documents covering the following topics: case management, integrated care, home treatment, crisis intervention services, transition from inpatient to outpatient care and vice versa, integrating general and mental healthcare, technology in care coordination and self-management, quality indicators, and economic evaluation. Based on the available evidence, we developed 15 recommendations for care coordination in European mental healthcare. Conclusions. Although evidence is limited, some concepts of care coordination seem to improve the effectiveness and efficiency of mental health services and outcomes on patient level. Further evidence is needed to better understand the advantages and disadvantages of different care coordination models.

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“…Challenges identified in this study centred around insufficient staff to deliver the service and to enable evaluation of outcome measures and cost effectiveness, similar to the findings of Parsonage et al (2014). Some of the more recent international studies in this area have focused 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 emergency department waiting times (Evans et al 2019) and overall cost savings benefits (Okoronkwo, 2019). However, there is little consistency in measurement and a 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: Similar Criticisms Have Also Been Made Bymentioning

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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A systematic review of proactive psychiatric consultation on hospital length of stay

Cited by 54 publications

References 31 publications

Is Consultation-Liaison Psychiatry ‘Getting Old’? How Psychiatry Referrals in the General Hospital Have Changed over 20 Years

Is Consultation-Liaison Psychiatry ‘Getting Old’? How Psychiatry Referrals in the General Hospital Have Changed over 20 Years

EPA guidance on the quality of mental health services: A systematic meta-review and update of recommendations focusing on care coordination

Understanding liaison psychiatry commissioning: an observational study

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