Elements of a successful short-stay inpatient psychiatric service.
In 1989 Johns Hopkins Hospital modified the Meyer 3 short-stay psychiatric service, which has allowed the hospital to comply with state requirements to control inpatient costs and has increased revenues. Strategies and organizational changes that were implemented to reduce length of stay include use of a screening tool by the admitting physician to ensure appropriate referrals to the service, modification of morning and afternoon rounds and strengthening of linkages with the psychiatric emergency department and outpatient services to enhance communication, replacement of inexperienced first-year residents in the emergency department with senior residents on 24-hour call who are closely supervised by short-stay service staff, and enhanced training for service nurses. Patients who are functionally disabled and who need assistance in activities of daily living have longer stays. Patients with substance use disorders are now referred to an ultra-short-stay unit.
Jayaram
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Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Tien
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Sullivan
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Gwon
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D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics; D015142:Baltimore; D002983:Clinical Competence; D003363:Cost Control; D003362:Cost-Benefit Analysis; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007396:Internship and Residency; D007902:Length of Stay / Q000191:economics*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000191:economics / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D010343:Patient Admission / Q000191:economics; D010348:Patient Care Team / Q000191:economics*; D010351:Patient Discharge / Q000191:economics; D011567:Psychiatric Department, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D011570:Psychiatry / Q000193:education; D011614:Psychotherapy, Brief / Q000191:economics*; D012017:Referral and Consultation / Q000191:economics; D016896:Treatment Outcome