Midgley S, Burns T, Garland C
St George's Hospital Medical School, London.
Br J Gen Pract. 1996 Feb;46(403):69-71.
Liaison meetings between psychiatrists and general practitioners are now well established. Much has been written about their purpose and structure but little about their content.
A study aimed to describe the clinical focus of meetings between a community mental health team and general practitioners and the nature of the professionals' interactions.
Audiotapes of six consecutive monthly meetings between a community mental health team and general practitioners in two general practices were analysed.
Attendance rates among professionals were over 70%. Over 90% of discussion time was focused on patient-centred clinical matters. Almost two thirds of interactions were focused on patients receiving ongoing joint care; few interactions were devoted to new referrals or to patients who had not been assessed. Psychotic patients, although accounting for 15% of referrals, occupied 54% of patient-centred discussion time. Most interactions consisted of reciprocal information exchange between members of the community mental health team and general practitioners.
The high attendance rates indicate that both general practitioners and community mental health team members considered these meetings as high priority. The steady move towards management of severely ill psychiatric patients in the community rather than in hospital requires close collaboration between primary and secondary care teams. The meetings described in this paper appear to be a simple, manageable and sustainable response to this need.
精神科医生与全科医生之间的联络会议如今已确立。关于其目的和结构已有诸多著述,但关于其内容的却很少。
一项研究旨在描述社区心理健康团队与全科医生之间会议的临床重点以及专业人员互动的性质。
对两个全科诊所中社区心理健康团队与全科医生连续六个月的月度会议录音进行了分析。
专业人员的出席率超过70%。超过90%的讨论时间集中在以患者为中心的临床问题上。近三分之二的互动集中在接受持续联合护理的患者身上;很少有互动涉及新转诊患者或未接受评估的患者。精神病患者虽然占转诊患者的15%,但却占据了以患者为中心讨论时间的54%。大多数互动包括社区心理健康团队成员与全科医生之间的相互信息交流。
高出席率表明全科医生和社区心理健康团队成员都将这些会议视为高度优先事项。社区而非医院对重症精神病患者的管理稳步推进,这需要初级和二级护理团队密切合作。本文所述的会议似乎是对这一需求的一种简单、可管理且可持续的应对措施。