Effectiveness of a standardised approach to the emergency assessments of psychiatric patients

Abstract

Objectives

This study sought to review implementation of a tool designed to standardise emergency assessments of psychiatric patients. Primary objectives were to reduce stay times and increase evidence-based work-up. Secondary objectives were to review triages and analyse confidence.

Methods

A closed loop audit cycle was performed to determine the difference between assessments prior to and after implementation of the tool. A baseline audit was followed by 2 month’s implementation. Emergency staff were then instructed to utilise the tool for psychiatric presentations and complete surveys. A Student’s t-test and two Chi-squared tests were conducted to examine stay time; evidence-based care; and triage, respectively.

Results

For pre-implementation, 355 participants were included with 333 for post-implementation. Stay time decreased by over 10% (p = .067) whilst participants receiving recommended work-up increased by almost 15% (p < .0001). The post-implementation period showed a decrease in triage ≥4 by almost 10% (p = .0004). The survey was unable to be assessed.

Conclusion

The substantial reductions in stay time and triage ≥4, coupled with the increase in appropriate work-up are promising findings. These indicate implementation of a tool designed to standardise emergency assessment of psychiatric patients will reduce care disparity between psychiatric and medical presentations. Further studies are needed.