Journal of Child and Adolescent Behavior
Open Access

Abstract

Background: Limited inpatient services lead to a large number of psychiatric patients boarding at the emergency department for duration of time before being transferred to the psychiatry inpatient wards. This poses unique challenges for the care of these patients as they spend time in the emergency rooms which are ill-equipped for their needs. It also increases the overcrowding in the ER and the need for nursing staff required for their care. Objectives: In this research audit we look at the length of stay for psychiatric patients boarding at the emergency room at Hamad General hospital which is the largest government hospital in the state of Qatar. We also looked at other parameters like, the number of psychiatric patients who leave the ER against medical advice of their own will, whether they return afterwards within a week or not, and also, how many of the boarding patients were treated and discharged without being transferred to the psychiatry hospital. Methodology: A Facility-based descriptive analytical cross-sectional retrospective study was carried out between the months of January 2017 and April 2017 for the boarding psychiatric patients at Hamad hospital Emergency department, to determine their situation and consequences after admission order by psychiatry medical staff. A total of 375 patients were included in the study. Data was analyzed using SPSS for windows (version 20.0) Results: It was found that out of the 357 boarding patients, only 95 (26.6%) spent less than 12 hours in the ED, and a cumulative of 115 patients spent more than 24 hours in the ED. What was also found was that from the 65 patients discharged by the psychiatry liaison team only 3 returned to the ER within 1 week. On an average, patients on either kind of nursing precaution (suicide or absconding) spent less time in the ER were transferred earlier than those not on precautions. No significant differences were found with regards to gender. Discussion: After reviewing the national mental health strategy, as mentioned in the introduction as well, it is deemed that a need of 319 psychiatric beds is present in the state of Qatar currently. The mental health strategy also highlights plans for expansion of psychiatric services in all the various disciplines like community and home care as well, in order to reduce the number of patients boarding in the ER which goes in line with the recommendations that are produced through this audit.

Biography

Huma Iram graduated from Gulf Medical University in Ajman, UAE, in 2009. She is a licensed, board certified psychiatrist, currently working in the position of a Clinical Fellow in Consultation Liaison Psychiatry in HMC. She finished her Residency in Psychiatry from HMC as well. Her area of expertise includes treating patients with psychosomatic illnesses presenting to the emergency department as well as consulting on patients with psychiatric/behavioral symptoms in the medical and surgical floors. She is active in various ongoing research projects in her institution.

E-mail: humairum@gmail.com