4Ds: Documenting delirium diagnosis in discharge summary

Z Azvee,I Khair,J Sheehan,N Barry

doi:10.1192/j.eurpsy.2021.1336

Z Azvee, I Khair + Show 2 more

Open Access

https://doi.org/10.1192/j.eurpsy.2021.1336

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Abstract

IntroductionHospital discharge is a significant transitional phase with varying levels of needs and risks to be managed as lapses in communication commonly happen between secondary/tertiary and primary care.ObjectivesOur aim was to look at inclusion of delirium diagnosis in discharge summaries based on standards set by: 1. Health Information and Quality Authority (HIQA) National Standard for Patient Discharge Summary Information 2. NICE Guidelines on Delirium: prevention, diagnosis and management (CG 103)MethodsAll inpatients referred to Liaison Psychiatry from 9thJuly 2019 till 5th January 2020 were included, n = 729. Compared discharge summaries diagnoses to the internal Liaison Psychiatry ICD 10 consensus diagnosis and also HIPE coded diagnosis specifically for delirium.ResultsDelirium diagnoses and inclusion of delirium-specific information on discharge summarynProportion (n=112*) (%)Q1 Any F05 diagnosis coded by Liaison Psychiatry117100Q2 F10.4 diagnosis coded by Liaison Psychiatry00Q3 F1x.4 diagnosis coded by Liaison Psychiatry00Q4 Any F05, F10.4 and F1x.4 diagnosis coded in discharge summary on patient centre2320.5Q5 Was the word delirium or its synonym such as acute confusional state mentioned in the body of the discharge summary?6255.4HIPE Code Diagnosis6658.9ConclusionsHospital discharge summaries are essentially the main communication link between hospitalists and general practitioners to ensure continuity and future care of patients. Delirium diagnosis is not always recorded in discharge summaries. This is a risk to be managed. Education is vital to ensure awareness, prevention, early recognition and to ensure recording of diagnosis of delirium.

Highlights

Mindfulness techniques, which are currently widely used in psychosomatics and psychotherapy, pose challenges when treating people coming from Buddhist groups for several reasons
As commitments to secrecy hinder people to ask for psychotherapy for long, they were asked on their thoughts about secrecy in Buddhist groups
On the basis of complex clinical anamnestic, clinical psychopatological, pathopsychological research, data were obtained about reasons and conditions of formation, abnormal clinical psychopathological structure, syndrome peculiarities of emotional disfunctions for patients with episodic paroxismal disorders, generalized anxiety disorders and mixed anxiously depressed disorders.To realize the aim and tasks of the research, 145 patients were examined with anxiety disorders, that passed the stationary course of treatment

Summary

Introduction

At Coombe Wood Mother and Baby unit (MBU) there are daily multi-disciplinary team (MDT) handover meetings and a weekly MDT ward round attended by 7-8 team members. Objectives: To perform a service evaluation to determine the efficiency and quality of MDT handover meetings in an MBU setting. A checklist was designed listing information felt to be relevant to handover and contained the following data points – ‘current situation’, ‘mental health’, ‘level of observations’, ‘risk’, ‘physical health’, ‘baby care’, ‘baby supervision levels’ and ‘tasks and responsibilities’. Results: Mean meeting duration was 32.2 minutes (range: 13 – 45 minutes) and amounted to 2.68 hours spent in MDT handover over a 5-day working week. This equates to 21.4 person-hours (based on 8 staff) a week. Involving MDT staff in designing interventions will make handover meetings more meaningful

Conclusions

Findings