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Implementation of Proactive Psychiatric Consultation With Cardiology Inpatients
Melissa Otte1, Laura Suarez Pardo2, Daniel Kinstler3
1Melissa Otte is Clinical Resource Nurse, Adult Acute Psychiatry and Consultation-Liaison Nursing, and Instructor of Nursing, Mayo Clinic, 1216 2nd St SW, Rochester, MN 55902 (otte.melissa@mayo.edu).
Background:
Cardiovascular disease is linked to mental health conditions. Patients with cardiovascular disease and comorbid psychiatric illnesses such as major depressive disorder or generalized anxiety disorder often experience greater physical limitations and decreased overall health.
Objective:
To determine if proactive psychiatric interventions improve staff satisfaction and patient outcomes, such as reducing length of stay and decreasing the 30-day readmission rate, for patients hospitalized on cardiac units with psychiatric comorbidities.
Methods:
The implementation of a proactive psychiatric consultation-liaison service, which included proactive screening of psychiatric needs among patients hospitalized on cardiac units, targeted support for cardiovascular staff, and supportive interactions for patients.
Results:
Comparison between preintervention and postintervention periods indicated a 21% reduction in the 30-day readmission rate for patients hospitalized on cardiac inpatient units with psychiatric comorbidities without adversely affecting hospital length of stay. Staff satisfaction significantly increased with the availability of psychiatric resources.
Conclusion:
The implementation of a multi-disciplinary proactive psychiatric consultation-liaison service on inpatient cardiac units was associated with an increase in cardiovascular staff satisfaction with psychiatric services and a decrease in the 30-day readmission rate of patients with psychiatric comorbidities who were hospitalized for cardiovascular services without significantly affecting length of stay.
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