Emergency Services, Psychiatric
Conditions
Brief summary
Psychiatric presentations are common in the emergency department (ED), and determining whether or not a psychiatric presentation is due to medical illness can be a difficult task for the emergency physician. The investigators define serious medical illness (SMI) as a pathological condition that would necessitate inpatient treatment on a medical or surgical ward. It is important for patient safety that SMI be triaged by the emergency physician to the appropriate inpatient service. The rate of missed SMI in patients with psychiatric presentations to the ED is unknown. The investigators will research missed SMI in patients referred to adult psychiatry from the ED, with the intent to improve patient safety.
Interventions
None listed
Sponsors
Western University, Canada
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All patients greater than or equal to 18 years of age presenting to London Health Sciences Centre, Victoria Hospital emergency department between October 1, 2014 - July 31, 2015 who were referred to adult psychiatry by the emergency physician.
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients admitted to a medical / surgical service within 7 days of psychiatry referral in the emergency department | Approximately 8 months | — |
| Medical / surgical admission diagnosis | Approximately 8 months | This will be extracted from the electronic medial record. |
| Number of days after psychiatric referral that patient is admitted to medical / surgical service | Approximately 8 months | — |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of patients discharged home from the emergency department by psychiatry following referral by the emergency physician | Approximately 8 months | — |
| Risk factors associated with medical / surgical admission after initial psychiatry referral | Approximately 8 months | The investigators will be extracting variables from the patient's chart including triage vital signs, past medical and psychiatric history, initial laboratory bloodwork, and determining if any of these are risk factors for subsequent medical / surgical admission. |
| Number of admissions to medical / surgical service within 30 days of discharge from psychiatry | Approximately 8 months | — |
Outcome results
None listed