Time study of psychiatric emergency service evaluations

Area of Science:

• Psychiatry
• Emergency Medicine
• Healthcare Management

Background:

• Psychiatric Emergency Service (PES) consultation times are crucial for resource allocation, especially during scarcity.
• Unlike medical emergency rooms, comprehensive PES facilities have dedicated space, staff, and holding units for psychiatric emergencies.
• Existing literature often focuses on medical emergency room evaluation durations, with less emphasis on PES-specific factors.

Purpose of the Study:

• To identify factors influencing the time course of consultations within a Psychiatric Emergency Service.
• To quantify the contribution of significant variables to the total evaluation time in a PES setting.

Main Methods:

• Review of 895 consecutive evaluations conducted at the PES during the first quarter of 1995.
• Application of Analysis of Variance (ANOVA) with multiple comparisons.
• Utilized multiple linear regression techniques to identify and quantify influential variables.

Main Results:

• Waiting times for psychiatric services were extended during day and evening shifts compared to night shifts.
• Substance abuse diagnoses, referrals from police/mobile teams, and the necessity for emergency medication increased waiting times.
• Contact time was longer during evening shifts, for patients requiring emergency medication or hospitalization, and those with prior hospitalization history.

Conclusions:

• High-acuity patients requiring behavioral management significantly affect psychiatric evaluation duration in PES.
• Unlike medical ERs where low-acuity patients experience the longest delays, PES delays are driven by complex psychiatric needs.
• Behavioral management, rather than diagnostic tests or consultations, represents a primary source of delay in PES.