In-House Implications of a 1-Year Retrospective Analysis of the Psychiatric Consultation-Service in a German University Hospital

Abstract

Objective: Due to major differences in patient populations, consultants and hospital settings of single-centres structured analyses of the psychiatric consultation-service (PCS) might be considered as an internal statistical appraisal for quality and efficacy improvements of the focused PCS. Method: The patient population given by the original documentation schedules of psychiatric consultations performed in the University hospital of Ulm in the year 2008 were analysed for the following variables: sex, age, requesting department, based problem or consultation query, allocated psychiatric diagnosis, therapeutic suggestion, occurrence and number of psychiatric consultations within the same case, acuteness level, diagnosis according to ICD-10 F and therapeutic recommendation. Results: In a total of n = 656 consultations most frequent questions were for: "medication", "diagnostic suggestions" and "no specific question", whereupon "no question" was given in 19%. A statement concerning the urgency-level of the consultation was present in 10.5%. Organic mental disorders, mood disorders, neurotic, stress-related and somatoform disorders formed 72% of all diagnoses. Pharmacotherapy was most frequently recommended. The detected shortcomings were mostly the result of heterogenous documentation. Conclusions: Frequent absence of relevant information throughout the consultation process gives reason for interdisciplinary arrangements to create a rational algorithm for PCS. Based on our findings standardization of our consultation reports was established by means of a standard form and a pocket-booklet which provides diagnostic guidelines and therapeutic recommendations.