Comparison of consultation-liaison psychiatry services for inner-city, district or regional general hospitals using a common tool: Does one size fit all?
OBJECTIVE
Consultation-liaison psychiatry (CLP) services vary in terms of structure, function and responsiveness. It is not known whether evaluation measurements can be meaningfully compared across different CLP services to assess value and efficiency. The aim was to develop and test a common tool for measuring process and outcome measures in CLP.


METHODS
A data collection tool was developed using the literature and consultation with CLP clinicians. The tool was used to prospectively gather referral data, response times, health utilisation data and functional outcomes for individuals referred over seven months to three different CLP teams, servicing inner city, district and regional areas.


RESULTS
The structure, staffing, liaison attachments and scope of practice varied between the services. The regional CLP service attended seven hospitals and had the highest referral rate and largest inpatient population pool. The three services received referrals for similar reasons and made similar diagnoses. Multimodal management was the norm, and CLP facilitated follow-up arrangements upon discharge. Only the district CLP service saw all emergency referrals within an hour. Age and need for an interpreter did not affect response times.


CONCLUSIONS
Despite local differences in geography, CLP roles, hospital and community mental health service pathways and patient populations, the CLP data collection tool was applicable across sites. Staff resourcing and referral demand are key determinants of CLP response times.
South Eastern Sydney Local Health District, NSW, Australia; Faculty of Medicine, University of New South Wales, NSW, Australia. Electronic address: a.wand@unsw.edu.au.
Anne P F
APF
Wand
Sydney Local Health District, NSW, Australia; Discipline of Psychiatry, Sydney Medical School, University of Sydney, NSW, Australia.
Rebecca
R
Wood
Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia; Graduate School of Medicine, University of Wollongong, Wollongong, NSW, Australia.
Matthew D
MD
Macfarlane
Sydney Local Health District, NSW, Australia; Discipline of Psychiatry, Sydney Medical School, University of Sydney, NSW, Australia.
Glenn E
GE
Hunt
D000328:Adult; D006767:Hospitals, District; D006769:Hospitals, General; D006801:Humans; D007297:Inpatients; D011570:Psychiatry / Q000458:organization & administration* / Q000639:trends; D012017:Referral and Consultation; D014505:Urban Population
Consultation–liaison psychiatry; Evaluation; Lagtime; Measurement; Quality improvement