title: Nurse-led liaison mental health service for older adults: service development using lean thinking methodology.
abstract: OBJECTIVE
  Liaison Psychiatric Services for Older Adults in the UK have been established over the last decade, with rather divergent team composition and involvement. The latest documents (National Dementia Strategy, Who Cares Wins) set the gold standard for liaison services for older adults in England, requiring a proactive approach to services and integrating assessment and treatment of mental disorder into routine general hospital practice. This requires a physical presence of liaison services in the hospital, with collaboration with medical colleagues.
  
  
  METHODS
  We have adopted the above strategy in a nurse-led liaison service working in a General District Hospital, and used the Toyota Production System.
  
  
  RESULTS
  In the current study we reflect on the 5 day rapid progress improvement workshops event for the liaison branch of the project, and describe the process of identifying real situation problems for the care of the medically ill, the involvement of the liaison team in their clinical care, and a feedback on the change in practice.
  
  
  CONCLUSIONS
  The novel approach of identifying areas for change in an ongoing nurse-led Liaison service for Older Adults resulted in improving access to mental health services for elderly medically ill inpatients and improved quality of their overall care.
authors.affiliation: Bowes Lyon Unit, Lanchester Road Hospital, Durham, UK.
authors.forename: Paula
authors.initials: P
authors.lastname: Atkinson
authors.forename: Elizabeta B
authors.initials: EB
authors.lastname: Mukaetova-Ladinska
mesh_terms: D000368:Aged; D003299:Cooperative Behavior; D003693:Delirium / Q000175:diagnosis / Q000451:nursing; D003704:Dementia / Q000175:diagnosis / Q000451:nursing; D003866:Depressive Disorder / Q000175:diagnosis / Q000451:nursing; D004493:Education; D057286:Electronic Health Records; D004739:England; D006284:Health Plan Implementation / Q000458:organization & administration; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D033183:Interdisciplinary Communication; D001523:Mental Disorders / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology; D008605:Mental Health Services / Q000458:organization & administration*; D009746:Nursing, Team; D010348:Patient Care Team; D011568:Psychiatric Nursing / Q000458:organization & administration*; D058996:Quality Improvement / Q000458:organization & administration; D012017:Referral and Consultation / Q000458:organization & administration*; D013222:State Medicine