Abstract
Background
Consultation-liaison psychiatry (CLP) provides mental health expertise in general hospitals, where psychiatric comorbidities affect approximately 30% of patients. Following implementation of a new electronic referral system at Waikato Hospital, this study aimed to analyse referral quality and service utilisation patterns.
Methods
A 12-month retrospective audit was conducted from July 2023 to June 2024, analysing all CLP referrals using a new system incorporating the Identify and Rate the Aim of the Contact (IRAC) tool and referral quality metrics. Referral quality was assessed both pre- and post-patient evaluation using a five-point Likert scale.
Results
Of 939 referrals (789 unique patients), 63.7% were rated as relevant to highly relevant. The average referral quality score was 2.698 pre-assessment and 2.682 post-assessment. General Medicine generated the most referrals, while Obstetrics/Gynaecology and Neurology showed lower quality scores. The mean time from admission to referral was 5.4 days. Risk assessment and management were the primary referral purposes, with 11.4% related to suicide attempts. Each referral averaged 3.64 contacts, with 20% of referrals consuming 54% of total contacts.
Conclusions
While most referrals were appropriate, quality scores below three indicate room for improvement. Findings suggest the need for targeted educational interventions and feedback mechanisms to enhance referral quality and optimise resource allocation in CLP services.
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