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Evaluation of the Psychiatric Decisions Unit (PDU): effect on emergency department presentations and psychiatric inpatient admissions
  1. Samuel P Trethewey1,
  2. Shantal Deepak2,
  3. Samuel Saad3,
  4. Ellen Hughes4,
  5. George Tadros4,5
  1. 1 Heart of England NHS Foundation Trust, Birmingham, UK
  2. 2 University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
  3. 3 University of Birmingham, Birmingham, UK
  4. 4 Department of Liaison Psychiatry, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
  5. 5 Aston Medical School, Aston University, Birmingham, UK
  1. Correspondence to Professor George Tadros, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK; george.tadros{at}nhs.net

Abstract

Background Busy emergency departments (EDs) are not the optimum environment for assessment of patients in mental health crisis. The Psychiatric Decisions Unit (PDU) was developed by the Birmingham and Solihull Mental Health Foundation Trust as an enhanced assessment service to ensure patients in mental health crisis receive optimal care.

Aims To evaluate the activities of the PDU and its impact on the frequency of ED presentations and inpatient admissions, and to explore patient satisfaction.

Methods Data were collected over a 6-month period during 2015 regarding patient demographics, referral sources, length of stay, and frequency of mental health-related ED presentations and inpatient psychiatric admissions. Comparison group data were used to evaluate the impact of the PDU. Patient satisfaction was measured using the ‘Friends and Family Test’ and structured feedback forms.

Results In total, 385 patients were referred to the PDU during the study period. Implementation of the PDU was associated with a 39% decrease in the number of patients taken to the ED by Street Triage and a 26% fall in inpatient psychiatric admissions via the Trusts’ in-hospital liaison psychiatry team. Ninety-eight per cent of patients surveyed felt that they were treated with respect and understanding, and 94% reported that they were likely or extremely likely to recommend the service to friends and family.

Conclusions Implementation of the PDU was associated with a reduction in the frequency of ED presentations and inpatient psychiatric admissions. This study suggests that patients are satisfied with the care provided at the PDU.

  • liaison psychiatry
  • emergency department
  • psychiatric admissions
  • service evaluation
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Footnotes

  • Contributors GT planned the study, and contributed to data interpretation and revision of the manuscript. EH contributed to data collection, data interpretation and revision of the manuscript. SPT, SD and SS contributed to data analysis/interpretation, revision of the manuscript and final approval for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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