The Development of an Outcome Measure for Consultation Liaison Psychiatry

Guthrie, Else; Harrison, Masuma; Brown, Ronald C.; Trigwell, Peter; Abraham, Seri; Kelsall, Peter; Sandhu, Rajdeep; Thomasson, Rachel; Nawaz, Shazada

doi:10.1016/j.jpsychores.2017.03.243

Cited by 2 publications

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“…The Royal College of Psychiatrists has published a Framework for Recording Outcomes and Measurement in Liaison Psychiatry [ 41 ], which should improve consistency in data collection, but the framework has not been universally adopted by services. A bespoke liaison symptomatic outcome measure has also been developed recently [ 42 ] but is not in widespread use.…”

Section: Resultsmentioning

confidence: 99%

A programme theory for liaison mental health services in England

House

Guthrie

Walker

et al. 2018

BMC Health Serv Res

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BackgroundMechanisms by which liaison mental health services (LMHS) may bring about improved patient and organisational outcomes are poorly understood. A small number of logic models have been developed, but they fail to capture the complexity of clinical practice.MethodWe synthesised data from a variety of sources including a large national survey, 73 in-depth interviews with acute and liaison staff working in hospitals with different types of liaison mental health services, and relevant local, national and international literature. We generated logic models for two common performance indicators used to assess organisational outcomes for LMHS: response times in the emergency department and hospital length of stay for people with mental health problems.ResultsWe identified 8 areas of complexity that influence performance, and 6 trade-offs which drove the models in different directions depending upon the balance of the trade-off. The logic models we developed could only be captured by consideration of more than one pass through the system, the complexity in which they operated, and the trade-offs that occurred.ConclusionsOur findings are important for commissioners of liaison services. Reliance on simple target setting may result in services that are unbalanced and not patient-centred. Targets need to be reviewed on a regular basis, together with other data that reflect the wider impact of the service, and any external changes in the system that affect the performance of LMHS, which are beyond their control.

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Section: Resultsmentioning

confidence: 99%

A programme theory for liaison mental health services in England

House

Guthrie

Walker

et al. 2018

BMC Health Serv Res

View full text Add to dashboard Cite

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“…This dilemma is important to resolve given that the recent investment in liaison services in England comes with an expectation that services will improve clinical reporting. The development of a new liaison-specific clinician-rated measure, may help to address this significant problem area [40]. Recent discussion of liaison services has emphasised their function as a rapid assessment and sign posting service [13,37].…”

Section: Discussionmentioning

confidence: 99%

The nature and activity of liaison mental services in acute hospital settings: a multi-site cross sectional study

Saraiva

Guthrie

Walker

et al. 2020

BMC Health Serv Res

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Background: To describe the clinical activity patterns and nature of interventions of hospital-based liaison psychiatry services in England. Methods: Multi-site, cross-sectional survey. 18 acute hospitals across England with a liaison psychiatry service. All liaison staff members, at each hospital site, recorded data on each patient they had face to face contact with, over a 7 day period. Data included location of referral, source of referral, main clinical problem, type of liaison intervention employed, staff professional group and grade, referral onto other services, and standard assessment measures. Results: A total of 1475 face to face contacts from 18 hospitals were included in the analysis, of which approximately half were follow-up reviews. There was considerable variation across sites, related to the volume of Emergency Department (ED) attendances, number of hospital admissions, and work hours of the team but not to the size of the hospital (number of beds). The most common clinical problems were co-morbid physical and psychiatric symptoms, self-harm and cognitive impairment. The main types of intervention delivered were diagnosis/formulation, risk management and advice. There were differences in the type of clinical problems seen by the services between EDs and wards, and also differences between the work conducted by doctors and nurses. Almost half of the contacts were for continuing care, rather than assessment. Eight per cent of all referrals were offered follow up with the LP team, and approximately 37% were referred to community or other services. Conclusions: The activity of LP services is related to the flow of patients through an acute hospital. In addition to initial assessments, services provide a wide range of differing interventions, with nurses and doctors carrying out distinctly different roles within the team. The results show the volume and diversity of LP work. While much clinical contact is acute and confined to the inpatient episode, the LP service is not defined solely by an assessment and discharge function; cases are often complex and nearly half were referred for follow up including liaison team follow up.

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The Development of an Outcome Measure for Consultation Liaison Psychiatry

Cited by 2 publications

References 0 publications

A programme theory for liaison mental health services in England

A programme theory for liaison mental health services in England

The nature and activity of liaison mental services in acute hospital settings: a multi-site cross sectional study

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