Quality and Safety
Background: To date, scarce structured guidelines for the assessment of service quality improvement interventions and service quality standards for Consultation Liaison Psychiatry Services (CLP) have been described (1-4). Our aim is to measure the impact of introducing an electronic triage referral system (ETR) and a proactive CLP model (PCL) during the COVID-19 pandemic by establishing key performance indicators (KPI).
Methods: Observational exploratory study conducted at the Hospital Clínico Red Salud-UCChristus, a teaching hospital in Santiago, Chile, ~400 beds. ETR was introduced in May 2020, and PCLP from May to August 2020. Data was collected from CLP discharged records, from January 2019 to September 2021. Study approved by our Ethical Review Board.
Results: We observed a constant increase in the number of referrals and assessments from 2019 to 2021. Most frequent referrals in 2019-2021 were made by the Internal Medicine team and the most common diagnosis was delirium. Two main KPIs were assessed:
Discussion: The ETR and PCL initiatives had an impact in our service, as observed in our KPIs ToR and SWI. Our CLP service has been able to adapt to service demands, by increasing staffing available working hours when needed and reducing time of response.
Conclusions: ToR may be a useful and easy to collect KPI to routinely monitor service efficiency. Still remains a challenge for our service to introduce qualitative parameters of service user satisfaction in a 360º fashion to integrate patients, family, referrers and CLP staff. Trials to assess the efficacy of introducing complex interventions such as ETR, PCL and KPI surveillance are needed.
Francisco Palacios, MD– Psychiatry Resident, Pontificia Universidad Católica de Chile, Santiago, Region Metropolitana, Chile
Constanza Caneo, MD, MSc– C-L Psychiatrist, Clinical Assistant Professor, Pontificia Universidad Católica de Chile, santiago, Region Metropolitana, Chile