Co-managed Care for Medical Inpatients, C-L vs C/L Psychiatry.

Area of Science:

• Quality Improvement
• Inpatient Psychiatry
• Healthcare Management

Background:

• Managing patients with co-morbid medical and psychiatric disorders presents challenges in general hospitals.
• Traditional Consultation-Liaison models may not fully address the needs of these complex patients.
• A philanthropic donation enabled a pilot program for co-managed psychiatric care.

Purpose of the Study:

• To evaluate the impact of a co-managed care model on length of stay (LOS) for medical patients with psychiatric comorbidities.
• To compare the efficiency of co-managed care with the traditional Consultation-Liaison model.
• To assess the potential for reducing hospital lost days through integrated psychiatric services.

Main Methods:

• Implemented a co-managed care model where an inpatient psychiatrist joined a general medical team.
• Compared time-to-consultation request and LOS between co-managed patients and those under the traditional Consultation-Liaison model.
• Initiated a quality improvement project focused on reducing lost patient days.

Main Results:

• Co-managed care patients experienced a reduced LOS compared to the traditional model.
• Co-managed patients received psychiatric consultations earlier in their hospitalization.
• Excluding outliers, LOS decreased by 1.19 days, yielding an estimated 2889 annualized patient day savings.

Conclusions:

• Co-managed care effectively reduces LOS and lost hospital days for patients with co-morbid psychiatric conditions.
• The program's success led to increased hospital investment in psychiatric liaison services.
• This model supports the integration of modernized psychiatric liaison programs into medical and surgical services.