Outpatient program decreases psychiatric admissions, readmission, length of stay

SAN DIEGO — An outpatient programed aimed at improving acute psychiatric care significantly reduced psychiatric admissions via the ED and length of stay among psychiatric admissions, according to data presented at the American Psychiatric Association Annual Meeting.

“Emergency department care for urgent psychiatric symptoms has dramatically increased, which has been shown in a number of studies in Ontario and North America since 2006,” Neeraj Bajaj, MBBS, MRCPsych, CCT, FRCP(C), of Queen’s University, Kingston, Ontario, Canada, said during a session here. “The problem with these increased presentations are that EDs are overcrowded. They're inundated with patients, often because we don’t have inpatient beds to send them to. Often, they're waiting in EDs for days before they get a bed. Lack of urgent psychiatric services can lead to readmission to EDs, which is a huge drain of resources.”

To assess the impact of the Intensive Transitional Treatment Program (ITTP), an outpatient program that offers intensive, rapid access to short-term multidisciplinary psychiatric treatment to individuals presenting to the ED and other acute services, researchers conducted a retrospective study of psychiatric ED presentation (n = 8,616) and admissions to the inpatient psychiatric unit (n = 1,862) at Kingston General Hospital.

Following ITTP implementation, median psychiatric admission length of stay significantly decreased (P = .03).

Psychiatric admissions via the ED significantly decreased (n = 134; P = .01).

Anonymized feedback from participants was very positive, according to researchers, and all surveyed participants recommended the program to others.

“We found that the ITTP program decreased the rate of psychiatric admissions, decreased the length of stay, decreased readmissions to the acute psychiatric unit and was quite pleasantly reviewed by patients,” study researcher Jonathan Fairbairn, a psychiatric resident at Queens University, Kingston, Ontario, said. “Looking at the literature, there wasn’t much in terms of how urgent psychiatric services should be modelled. We felt that this adds to showing how services can be implemented both as an alternative to acute care use hospitalization and also as a transitional service.” – by Amanda Oldt

Reference:

Bajaj N, et al. Intensive transitional treatment programme: Impact on psychiatric emergency admissions and length of stay on the inpatient unit. Presented at: American Psychiatric Association Annual Meeting; May 20-24, 2017; San Diego.

Disclosure: Bajaj reports no relevant financial disclosures.