Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists
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Australas Psychiatry · Apr 2012
Impact of a psychiatric unit's daily discharge rates on emergency department flow.
To investigate relationships between time spent in the emergency department (ED) in patients requiring admission to the psychiatric ward, the day of the week of presentation and the daily number of discharges from the psychiatric ward. ⋯ These findings demonstrate that patient flow is significantly slower on weekends because of fewer discharges from the ward, leading to longer times spent in the ED before ward transfer. Waiting times in the ED were very substantially greater than the proposed 4-hour target even when vacant beds were available, raising considerable doubt about that target being realistic for psychiatric patients.
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Australas Psychiatry · Dec 2011
Child and adolescent mental health problems and substance use presentations to an emergency department.
The aim of this study was to determine the characteristics and referral pattern of children and adolescents with mental health problems, substance misuse and comorbidity presenting to the emergency department (ED) of a large public hospital. ⋯ This age group places a high demand on the ED. All children and adolescents with recognized mental health symptoms were seen by mental health services, but those with substance misuse were not. Given the long-term problems associated with substance misuse, this is a missed opportunity for intervention.
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Australas Psychiatry · Oct 2011
"Big MAC": the role of consultation liaison psychiatry in hospital medical advisory committees.
The aim of this paper is to describe the participation of a consultation-liaison (CL) psychiatrist within a hospital medical advisory committee (MAC) and examine how this may generally contribute to improved patient care as well as assist in the development of governance within the hospital. ⋯ Psychiatrists have a role in a MAC in enhancing the recognition of psychiatric care issues within the hospital, educating other members of the committee with respect to improved recognition of mental illness affecting hospital inpatients and enhanced care of patients requiring substitute decision-making. The psychiatrist also has a role in advising the committee on psychosocial issues generally affecting the hospital service as well as informing on psychological issues that impact on hospital staff performance. To an extent, CL psychiatry also encompasses issues involving all the other medical craft groups in hospitals, offering the opportunity for a "global" perspective that may be expressed through participation in a MAC.
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Australas Psychiatry · Aug 2011
Critically appraising qualitative research: a guide for clinicians more familiar with quantitative techniques.
Papers using qualitative methods are increasingly common in psychiatric journals. This overview is an introduction to critically appraising a qualitative paper for clinicians who are more familiar with quantitative methods. ⋯ Qualitative research uses data from interviews (semi-structured or unstructured), focus groups, observations or written materials. Data analysis is inductive, allowing meaning to emerge from the data, rather than the more deductive, hypothesis centred approach of quantitative research. This overview compares and contrasts quantitative and qualitative research methods. Quantitative concepts such as reliability, validity, statistical power, bias and generalisability have qualitative equivalents. These include triangulation, trustworthiness, saturation, reflexivity and applicability. Reflexivity also shares features of transference. Qualitative approaches include: ethnography, action-assessment, grounded theory, case studies and mixed methods. Qualitative research can complement quantitative approaches. An understanding of both is useful in critically appraising the psychiatric literature.
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Australas Psychiatry · Aug 2011
Improving the care of mentally ill patients in a tertiary emergency department: development of a psychiatric assessment and planning unit.
The aim was to describe the Psychiatric Assessment and Planning Unit (PAPU), established at the Royal Melbourne Hospital (RMH) to improve access to psychiatric care for patients presenting via the Emergency Department (ED). ⋯ The establishment of the PAPU at RMH has resulted in significant improvement in the care of patients with mental illness in the least restrictive environment, based on decreased LOS and need for interventions.