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Implementation and evaluation of a proactive consultation-liaison model on an inpatient obstetric unit.
Lebin, Lindsay G; Nouri, Parvaneh K; Kwitowski, Melissa A; Dempsey, Allison G; Lebin, Jacob A; Nagle-Yang, Sarah.
Afiliación
  • Lebin LG; University of Colorado School of Medicine, Department of Psychiatry, 1890 North Revere Court, Suite, 5003, Aurora, CO, USA. Electronic address: Lindsay.lebin@ucdenver.edu.
  • Nouri PK; University of Colorado School of Medicine, Department of Psychiatry, 1890 North Revere Court, Suite, 5003, Aurora, CO, USA.
  • Kwitowski MA; University of Colorado School of Medicine, Department of Psychiatry, 1890 North Revere Court, Suite, 5003, Aurora, CO, USA.
  • Dempsey AG; University of Colorado School of Medicine, Department of Psychiatry, 1890 North Revere Court, Suite, 5003, Aurora, CO, USA.
  • Lebin JA; University of Colorado School of Medicine, Department of Emergency Medicine, 12401 East 17(th) Avenue, 7(th) floor, Aurora, CO, USA.
  • Nagle-Yang S; University of Colorado School of Medicine, Department of Psychiatry, 1890 North Revere Court, Suite, 5003, Aurora, CO, USA.
Gen Hosp Psychiatry ; 90: 124-131, 2024.
Article en En | MEDLINE | ID: mdl-39178701
ABSTRACT

OBJECTIVE:

Perinatal mental and anxiety disorders (PMADs) contribute to adverse health outcomes, though they are underrecognized and undertreated. Inpatient obstetric settings represent a unique opportunity for behavioral health engagement, including screening, brief treatment, and referrals for outpatient care. The proactive consultation-liaison (CL) model has proven effective in general hospital settings but is not well-studied in obstetric settings. This article describes the implementation and evaluation of a proactive CL model in an inpatient obstetric unit within a tertiary medical center.

METHODS:

We implemented a multidisciplinary, proactive CL model in an inpatient obstetric unit with the purpose of identifying patients at risk for or experiencing PMADs and providing intervention and/or referral to treatment. Systematic screening of 7322 admitted patients was performed over a 17-month period to identify eligible patients for behavioral health consultation. Consultation data was retrospectively extracted from the electronic medical record. Key implementation outcomes were assessed using a RE-AIM measures (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework.

RESULTS:

1589 initial consults were conducted by the multidisciplinary team, yielding a consult rate of 21.7 %. The majority of consults (94 %) were completed by a social worker or psychologist, with most patients identified for consultation at multidisciplinary rounds (60.7 %). The most common indications for consultation with a psychiatrist included medication management, history of bipolar disorder, and history of anxiety. All invited staff and providers participated in the model. Alternative funding sources agreed to cover the salaries of the multidisciplinary team following conclusion of pilot grant funding.

CONCLUSIONS:

A proactive CL model implemented in an inpatient obstetric unit led to a higher consult rate (21.7 %) than is observed with traditional CL services. A multidisciplinary proactive CL model shows promise in identifying people at-risk for PMADs and providing targeted interventions to prevent PMADs and treat those with active symptoms.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derivación y Consulta Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Gen Hosp Psychiatry Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derivación y Consulta Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Gen Hosp Psychiatry Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos