Patient flow from emergency department to inpatient psychiatric unit - a narrative review

To review the literature on common issues impacting psychiatric patient flow in emergency departments (EDs) and to explore evidence-based solutions proposed to improve patient flow.

The review was divided into three parts and a broad array of keywords were chosen to achieve greater depth in the review. Administrative data and organisational publications were included along with peer-reviewed articles in various databases.

Psychiatric patients have increased ED length of stay (EDLOS) and the proportion of psychiatric presentations in ED has increased significantly.¹ Several factors contributed to increased EDLOS. Introduction of psychiatric short stay units,² improving patient flow³ and appropriate increase in beds were identified as some of the possible solutions to improve patient flow.

Psychiatric patient flow in ED is a complex issue and needs a coordinated approach to improve access. Future studies should focus on understanding the effectiveness of some of the proposed strategies.