Book contents
- Frontmatter
- Contents
- Editors
- Contributors
- Foreword
- Preface
- Introduction
- Completing an audit project
- I Disorders
- II Legislation
- III Physical health
- IV Record-keeping
- V Service provision
- 54 Early intervention teams
- 55 Emergency department: attendance
- 56 Information for in-patients on their rights
- 57 Interpreters
- 58 Liaison psychiatry: response time to referrals
- 59 Multi-agency working
- 60 Personal searches
- 61 Prison equivalence
- 62 Prison-to-hospital transfers
- 63 Seven-day follow-up
- 64 Substance misuse: Treatment Outcomes Profile
- 65 Transition from ‘choice’ to ‘partnership’ in the Choice and Partnership Approach
- 66 Transition planning in attention-deficit hyperactivity disorder
- 67 Violent incidents: management
- 68 Waiting times
- VI Training
- VII Treatment
- Appendices
55 - Emergency department: attendance
from V - Service provision
Published online by Cambridge University Press: 02 January 2018
- Frontmatter
- Contents
- Editors
- Contributors
- Foreword
- Preface
- Introduction
- Completing an audit project
- I Disorders
- II Legislation
- III Physical health
- IV Record-keeping
- V Service provision
- 54 Early intervention teams
- 55 Emergency department: attendance
- 56 Information for in-patients on their rights
- 57 Interpreters
- 58 Liaison psychiatry: response time to referrals
- 59 Multi-agency working
- 60 Personal searches
- 61 Prison equivalence
- 62 Prison-to-hospital transfers
- 63 Seven-day follow-up
- 64 Substance misuse: Treatment Outcomes Profile
- 65 Transition from ‘choice’ to ‘partnership’ in the Choice and Partnership Approach
- 66 Transition planning in attention-deficit hyperactivity disorder
- 67 Violent incidents: management
- 68 Waiting times
- VI Training
- VII Treatment
- Appendices
Summary
Setting
This audit may be particularly relevant to liaison psychiatry services and other mental health services that accept referrals from emergency departments.
Background
The NHS Plan introduced an aim to reduce waiting times for patients attending emergency departments (Department of Health, 2000). This audit aimed to measure the proportion of patients referred to mental health services who remained in an emergency department for longer than 4 hours and to identify the reasons for prolonged attendance.
Standards
The standard was derived from the NHS Plan, which stipulated that, from 2004 onwards, over 98% of patients attending an emergency department should have completed their attendance episode within 4 hours (Department of Health, 2000). This time includes any assessment and management by specialist services that occurs in the emergency department. The standard set was that over 98% of referrals to liaison psychiatry should have an attendance time of under 4 hours.
Method
Data collection
Emergency department records were collected for all patients who were referred by the emergency department to the liaison psychiatry service over a 3-month period. For each attendance, the total attendance time was calculated. Where the attendance time was over 4 hours, the records were examined to identify the main reasons for a prolonged attendance.
Data analysis
Two time intervals were calculated, between:
ᐅ booking into the emergency department and assessment by a doctor
ᐅ referral to the liaison psychiatry service and psychiatric assessment.
For both intervals, an arbitrary duration of greater than 1 hour was recorded as contributing to a prolonged attendance.
Resources required
People
Cooperation is required from emergency department staff in order to collect patient records. It is suggested that the audit is undertaken by at least two people, owing to the amount information to be collected and the possible need to confer when points are uncertain. It is recommended that the auditors are clinical staff who are familiar with clinical records and emergency department care.
Time
The audit should be conducted over a long enough period to gain a representative number of cases (e.g. 3 months). It is estimated that data collection would take 15–20 hours.
- Type
- Chapter
- Information
- 101 Recipes for Audit in Psychiatry , pp. 137 - 138Publisher: Royal College of PsychiatristsPrint publication year: 2011