Bourgeois James A, Hilty Donald M, Klein Sally C, Koike Alan K, Servis Mark E, Hales Robert E
University of California, Davis Medical Center, Department of Psychiatry, Sacramento, CA 95817, USA.
Gen Hosp Psychiatry. 2003 Jul-Aug;25(4):262-8. doi: 10.1016/s0163-8343(03)00040-9.
The perspective of the contemporary Consultation-Liason Service (CLS) psychiatrist is increasingly one of consultant to medical and surgical colleagues in models other than inpatient medical and surgical units. Simultaneously, the need for a clinically and educationally robust inpatient CLS persists despite funding pressures. The University of California, Davis Medical Center Department of Psychiatry has made use of creative organizational and financial models to accomplish the inpatient CLS clinical and educational missions in a fiscally responsible manner. In addition, the department has in recent years expanded the delivery of psychiatry consultation-liaison clinical and educational services to other models of care delivery, broadening the role and influence of the CLS. Several of the initiatives described in this paper parallel an overall evolution of the practice of consultation-liaison psychiatry in response to managed care influences and other systems pressures. This consultation-liaison paradigm expansion with diversified sources of funding support facilitates the development of consultation-liaison psychiatry along additional clinical, administrative, research, and educational dimensions. Other university medical centers may consider adaptation of some of the initiatives described here to their institutions.
当代会诊-联络服务（CLS）精神科医生的角色越来越多地体现在为内科和外科同事提供咨询，而非局限于住院内科和外科病房。与此同时，尽管面临资金压力，但临床上和教育上强大的住院CLS仍有需求。加利福尼亚大学戴维斯分校医学中心精神病学系利用创新的组织和财务模式，以对财政负责的方式完成住院CLS的临床和教育任务。此外，该系近年来已将精神科会诊-联络临床和教育服务扩展到其他护理模式，扩大了CLS的作用和影响力。本文所述的多项举措与会诊-联络精神病学实践的整体演变并行，以应对管理式医疗的影响和其他系统压力。这种由多元化资金支持的会诊-联络模式扩展，促进了会诊-联络精神病学在临床、管理、研究和教育等其他维度的发展。其他大学医学中心或许可以考虑将这里描述的一些举措应用于其机构。
