Missed Serious Medical Illness in Psychiatric Patients Seen in an Academic Emergency Department

• Conditions: Emergency Services, Psychiatric

• Registration Number: NCT02581267
• Lead Sponsor: Western University, Canada

Brief Summary

Psychiatric presentations are common in the emergency department (ED), and determining whether or not a psychiatric presentation is due to medical illness can be a difficult task for the emergency physician. The investigators define "serious medical illness" (SMI) as a pathological condition that would necessitate inpatient treatment on a medical or surgical ward. It is important for patient safety that SMI be triaged by the emergency physician to the appropriate inpatient service. The rate of missed SMI in patients with psychiatric presentations to the ED is unknown. The investigators will research missed SMI in patients referred to adult psychiatry from the ED, with the intent to improve patient safety.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2015-08-08
• Status Verified: 2015-10
• Study Start: 2015-10
• Study First Submitted QC: 2015-10-19
• Last Update Submitted: 2015-10-19
• Study First Posted: 2015-10-20
• Last Update Posted: 2015-10-20
• Primary Completion: 2015-12
• Study Completion: 2015-12

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 800

Inclusion Criteria

• All patients greater than or equal to 18 years of age presenting to London Health Sciences Centre, Victoria Hospital emergency department between October 1, 2014 - July 31, 2015 who were referred to adult psychiatry by the emergency physician.

Exclusion Criteria

• None

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Number of patients admitted to a medical / surgical service within 7 days of psychiatry referral in the emergency department	Approximately 8 months
Medical / surgical admission diagnosis	Approximately 8 months	This will be extracted from the electronic medial record.
Number of days after psychiatric referral that patient is admitted to medical / surgical service	Approximately 8 months

Secondary Outcome Measures

Name	Time	Method
Proportion of patients discharged home from the emergency department by psychiatry following referral by the emergency physician	Approximately 8 months
Risk factors associated with medical / surgical admission after initial psychiatry referral	Approximately 8 months	The investigators will be extracting variables from the patient's chart including triage vital signs, past medical and psychiatric history, initial laboratory bloodwork, and determining if any of these are risk factors for subsequent medical / surgical admission.
Number of admissions to medical / surgical service within 30 days of discharge from psychiatry	Approximately 8 months