Abstract
Background: We describe the way psychiatric issues are addressed by inpatient medical teams through analysis of discussions of patients with behavioral health concerns and examination of teams' subsequent consultation practices. Methods: We observed morning rounds for nine inpatient medical teams for approximately month-long periods, for a total of 1941 observations. We compared discussions of patients admitted for behavioral health related medical conditions between those who did and did not receive a psychiatric consultation, developing categories to describe factors influencing consultation or other management. Results: Out of 536 patients, 40 (7.5%) received a psychiatry consult. Evaluation of a known concern (i.e., substance use, affective disorder, or suicidal ideation) was the most common reason for referral (41.7%). Requests for medication review were second (30.6%). Thirty patients with concomitant behavioral and medical health issues did not receive a psychiatry consult. Cirrhosis with active substance use was the most common medical diagnosis (15), followed by alcohol withdrawal (9). Conclusions: Four primary themes emerged from our data: positive identification of behavioral health issues by physicians, medication management as a primary reason for referral, patient preference in physician decision-making, and poor management of substance abuse. Our results identify two potential areas where skills-building for inpatient physicians could have a positive impact: management of medication and of substance abuse management.
| Original language | English (US) |
|---|---|
| Article number | 336 |
| Journal | BMC Health Services Research |
| Volume | 18 |
| Issue number | 1 |
| DOIs | |
| State | Published - May 8 2018 |
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Keywords
- Comorbidity
- Inpatient medicine
- Psychiatric consultation
ASJC Scopus subject areas
- Health Policy
Cite this
Psychiatric consultation requests by inpatient medical teams : An observational study. / Pezzia, Carla; Pugh, Jacqueline A; Lanham, Holly L; Leykum, Luci K.
In: BMC Health Services Research, Vol. 18, No. 1, 336, 08.05.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Psychiatric consultation requests by inpatient medical teams
T2 - An observational study
AU - Pezzia, Carla
AU - Pugh, Jacqueline A
AU - Lanham, Holly L
AU - Leykum, Luci K
PY - 2018/5/8
Y1 - 2018/5/8
N2 - Background: We describe the way psychiatric issues are addressed by inpatient medical teams through analysis of discussions of patients with behavioral health concerns and examination of teams' subsequent consultation practices. Methods: We observed morning rounds for nine inpatient medical teams for approximately month-long periods, for a total of 1941 observations. We compared discussions of patients admitted for behavioral health related medical conditions between those who did and did not receive a psychiatric consultation, developing categories to describe factors influencing consultation or other management. Results: Out of 536 patients, 40 (7.5%) received a psychiatry consult. Evaluation of a known concern (i.e., substance use, affective disorder, or suicidal ideation) was the most common reason for referral (41.7%). Requests for medication review were second (30.6%). Thirty patients with concomitant behavioral and medical health issues did not receive a psychiatry consult. Cirrhosis with active substance use was the most common medical diagnosis (15), followed by alcohol withdrawal (9). Conclusions: Four primary themes emerged from our data: positive identification of behavioral health issues by physicians, medication management as a primary reason for referral, patient preference in physician decision-making, and poor management of substance abuse. Our results identify two potential areas where skills-building for inpatient physicians could have a positive impact: management of medication and of substance abuse management.
AB - Background: We describe the way psychiatric issues are addressed by inpatient medical teams through analysis of discussions of patients with behavioral health concerns and examination of teams' subsequent consultation practices. Methods: We observed morning rounds for nine inpatient medical teams for approximately month-long periods, for a total of 1941 observations. We compared discussions of patients admitted for behavioral health related medical conditions between those who did and did not receive a psychiatric consultation, developing categories to describe factors influencing consultation or other management. Results: Out of 536 patients, 40 (7.5%) received a psychiatry consult. Evaluation of a known concern (i.e., substance use, affective disorder, or suicidal ideation) was the most common reason for referral (41.7%). Requests for medication review were second (30.6%). Thirty patients with concomitant behavioral and medical health issues did not receive a psychiatry consult. Cirrhosis with active substance use was the most common medical diagnosis (15), followed by alcohol withdrawal (9). Conclusions: Four primary themes emerged from our data: positive identification of behavioral health issues by physicians, medication management as a primary reason for referral, patient preference in physician decision-making, and poor management of substance abuse. Our results identify two potential areas where skills-building for inpatient physicians could have a positive impact: management of medication and of substance abuse management.
KW - Comorbidity
KW - Inpatient medicine
KW - Psychiatric consultation
UR - http://www.scopus.com/inward/record.url?scp=85046670078&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85046670078&partnerID=8YFLogxK
U2 - 10.1186/s12913-018-3171-1
DO - 10.1186/s12913-018-3171-1
M3 - Article
C2 - 29739414
AN - SCOPUS:85046670078
VL - 18
JO - BMC Health Services Research
JF - BMC Health Services Research
SN - 1472-6963
IS - 1
M1 - 336
ER -