PhD candidate, Monash
Examining hoe time targets in Emergency has resulted in short cuts in psychiatric risk assessment
Patient demand is increasing across the world for EDs. National Emergency Access Targets (NEAT) were introduced to increase ED through put. While there are positives to this, it has promoted a culture of rushing and short cuts.
This is the first study in the world examining the impact NEAT has on psychiatric assessment in EDs. This is a complex area, where assessment of multiple psychological, medical, and social risks / needs require comprehensive assessment.
While NEAT has resulted in better communication and some streamlining of documentation, it has also created pressure on ED clinicians to meet four hours time targets.
Of note, there has been a significant impact on dealing with families in a psychiatric crisis. In a metropolitan based study involving 7 EDs, many mental health clinicians reported when they were in a hurry, family work was the first sacrifice made.
This has significant collateral and safety implications for a high risk patient group when it comes to ensuring comprehensive assessment, and safe discharging.
NEAT is being implemented in EDs across the world and further investigation into it's impact on psychiatric risks assessment and management, and further consideration to ED resourcing if NEAT targets continue to be such a high focus for administrators.
Abstract: The objective was to investigate how telepsychiatry works in the assessment of psychiatric emergency patients. Sixty consecutive patients referred to the acute open ward having their first psychiatric contact through the videolink with the psychiatrist on duty. Only minor technical problems occurred. The results suggest both acceptance and satisfaction on the part of patients and staff with new technology, instead of waiting for a consultation or traveling to see a psychiatrist in face-to-face meeting. Telepsychiatry seems to be suitable for the assessment of psychiatric emergency patients, and satisfactory for patients and staff alike.
Pub.: 10 Sep '05, Pinned: 25 Aug '17