The Psychiatric Emergency Research Collaboration-01: methods and results
AuthorsBoudreaux, Edwin D.
Allen, Michael H.
Currier, Glenn W.
California Pacific Medical Center
Camargo, Carlos A. Jr.
UMass Chan AffiliationsDepartment of Emergency Medicine
Emergency Services, Psychiatric
Health Services Research
Mental Status Schedule
Multicenter Studies as Topic
Quality Assurance, Health Care
Quality Indicators, Health Care
Referral and Consultation
Substance Abuse Detection
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AbstractOBJECTIVE: To describe the Psychiatric Emergency Research Collaboration (PERC), the methods used to create a structured chart review tool and the results of our multicenter study. METHOD: Members of the PERC Steering Committee created a structured chart review tool designed to provide a comprehensive picture of the assessment and management of psychiatric emergency patients. Ten primary indicators were chosen based on the Steering Committee's professional experience, the published literature and existing consensus panel guidelines. Eight emergency departments completed data abstraction of 50 randomly selected emergency psychiatric patients, with seven providing data from two independent raters. Inter-rater reliability (Kappas) and descriptive statistics were computed. RESULTS: Four hundred patient charts were abstracted. Initial concordance between raters was variable, with some sites achieving high agreement and others not. Reconciliation of discordant ratings through re-review of the original source documentation was necessary for four of the sites. Two hundred eighty-five (71%) subjects had some form of laboratory test performed, including 212 (53%) who had urine toxicology screening and 163 (41%) who had blood alcohol levels drawn. Agitation was present in 220 (52%), with 98 (25%) receiving a medication to reduce agitation and 22 (6%) being physically restrained. Self-harm ideation was present in 226 (55%), while other-harm ideation was present in 82 (20%). One hundred seventy-nine (45%) were admitted to an inpatient or observation unit. CONCLUSION: Creating a common standard for documenting, abstracting and reporting on the nature and management of psychiatric emergencies is feasible across a wide range of health care institutions.
SourceGen Hosp Psychiatry. 2009 Nov-Dec;31(6):515-22. Epub 2009 Jun 4. Link to article on publisher's site
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/28519
Related ResourcesLink to Article in PubMed