Nagi Tarika, Somvanshi Saurabh, Balasubramania Pandian Gautam Shanmuga Dharmar, Mohan Subbulakshmi, Altonen Brian
Psychiatry, Columbia University College of Physicians and Surgeons, Harlem Hospital Center, New York, USA.
Psychiatry and Behavioral Sciences, Columbia University College of Physicians and Surgeons, Harlem Hospital Center, New York, USA.
Cureus. 2023 Feb 9;15(2):e34801. doi: 10.7759/cureus.34801. eCollection 2023 Feb.
Background Our study's primary objective is to audit the resource utilization of a consultation-liaison (CL) psychiatry service in an inner New York City safety net hospital. This cross-sectional, observational study was conducted as a subset of a quality improvement project at the hospital to investigate the characteristics of the emergent nature of consults, types, and the specialty from which the referral was placed to the CL services. This study aims to improve the efficacy of our consult process by improving the appropriateness and precision of consult requests. Methodology This cross-sectional, observational study was reviewed and approved by the Institutional Review Board under a quality improvement exemption. The study investigated the EPIC electronic medical record data for characteristics of consult referrals in the third quarter of 2019 from July 1, 2019, to September 30, 2019. A total of 629 consults were recorded during this period. We excluded follow-up calls, duplicate data rows, and patients with missing data points; the final consults were 421. Patients who required more than one new consult (follow-up excluded) within 90 days were considered; thus, the total number of patients who were included in the study was 327. Results Of the 421 consults identified in the dataset for review, only 45.8% were valid consults, 32.8% were not valid, and 21.4% were uncertain. Further, the most common department from which consults were placed was Medicine (73.2%), followed by Surgery (12.8%), Obstetrics/Gynecology (9%), Critical Care (3.6%), and, finally, Pediatrics (1.4%). Conclusions The study overviews the quality of general consults for the CL psychiatry service and how the CL staff manages it. It also provides an idea about the number of consults that can be comprehensively addressed.
背景 我们研究的主要目的是审核纽约市内部安全网医院会诊-联络（CL）精神科服务的资源利用情况。这项横断面观察性研究是作为该医院质量改进项目的一个子集进行的，旨在调查会诊的紧急性质特征、类型以及转诊至CL服务的科室。本研究旨在通过提高会诊请求的适当性和精确性来提高我们会诊流程的效率。方法 这项横断面观察性研究在质量改进豁免下经机构审查委员会审查并批准。该研究调查了2019年第三季度（2019年7月1日至2019年9月30日）EPIC电子病历中会诊转诊的特征。在此期间共记录了629次会诊。我们排除了随访电话、重复数据行以及有数据缺失点的患者；最终有效的会诊为421次。考虑了90天内需要不止一次新会诊（不包括随访）的患者；因此，纳入研究的患者总数为327人。结果 在数据集中确定用于审查的421次会诊中，只有45.8%是有效会诊，32.8%无效，21.4%不确定。此外，提出会诊的最常见科室是内科（73.2%），其次是外科（12.8%）、妇产科（9%）、重症监护（3.6%），最后是儿科（1.4%）。结论 该研究概述了CL精神科服务一般会诊的质量以及CL工作人员如何进行管理。它还提供了关于可以全面处理的会诊数量的概念。
