Title: Reducing transfers of psychiatric inpatients to emergency rooms of general hospitals in Singapore: a clinical practice improvement project
year: 2017
Journal: Int J Psychiatry Clin Pract
Volume: 21
Issue: 1
Pages: 50-57
date: Mar
ISSN: 1471-1788 (Electronic);1365-1501 (Linking)
Article Number: 27686183
Keywords: Emergency Service, Hospital/*standards/statistics & numerical data;Health Services Research;Hospitals, General/*standards/statistics & numerical data;Hospitals, Psychiatric/*standards/statistics & numerical data;Humans;Mentally Ill Persons/*statistics & numerical data;Patient Transfer/*standards/statistics & numerical data;*Quality Improvement;Referral and Consultation/*standards/statistics & numerical data;Singapore;Psychiatric hospital;integrated care;medical referrals;quality improvement
Abstract: OBJECTIVE: Patients admitted to a psychiatric hospital commonly suffer from comorbid medical problems which sometimes require urgent medical attention. Twenty-two percent of emergency medical transfers from the Institute of Mental Health (IMH) to the emergency rooms of general hospitals were preventable and could be managed at IMH itself. We undertook a quality improvement project to understand the reasons behind such preventable referrals and implemented changes to address this. METHODS: Using the model for improvement, we deconstructed our processes and analysed root causes for such preventable referrals. Thereafter changes were implemented with Plan-Do-Study-Act (PDSA) cycles to analyse their outcomes. RESULTS: During the 6-month study period, we achieved a 100% reduction in preventable referrals through strategies aimed at reducing pressure on our on-call physicians in the making of medical decisions, maximising usage of our medical resources, constant education and raising awareness of this issue. CONCLUSIONS: Reducing preventable transfer of inpatients from a psychiatric hospital to the emergency departments of general hospitals is a worthwhile endeavour. Such initiatives optimise use of healthcare resources, improve patient care and increase satisfaction.
Notes: Low, Tchern Kuang Lambert;Tay, Kai Hong;Fang, Tina;Fung, Daniel Shuen Sheng;eng;England;2016/10/01 06:00;Int J Psychiatry Clin Pract. 2017 Mar;21(1):50-57. doi: 10.1080/13651501.2016.1235203. Epub 2016 Sep 30.
URL: https://www.ncbi.nlm.nih.gov/pubmed/27686183;https://www.tandfonline.com/doi/full/10.1080/13651501.2016.1235203
URI: https://open-access.imh.com.sg/handle/123456789/5143
Authors Address: a Institute of Mental Health , Singapore.
Appears in Collections:2017

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