160Rapid Assessment Interface And Discharge (Raid-Newport): Service Evaluation Of An Enhanced Older Adult Psychiatry Liaison Service

Abstract

Background: The existing Newport Older Adult Mental Health (OAMH) liaison service was unable to provide escalating needs to the older and increasingly frail patients currently being admitted to Royal Gwent Hospital (RGH). Therefore, Newport Rapid Assessment Interface Discharge (RAID) was set up to provide a prompt holistic assessment (Singh I et al. Clin Interv Aging 2013;8:1101-1108). The objective of this study was to appraise outcome measures with this enhanced service (Tadros G et al. Psychiatrist. 2013;37:4-10). Method(s): The existing nurse led psychiatry liaison team was expanded to provide an enhanced multidisciplinary input by increasing nurse provision, introducing therapists, social worker input and a dedicated old age psychiatry consultant on weekdays between 9 am and 5 pm. Patient demographics, social care needs, co-morbidity burden (Charlson Co-morbidity Index - CCI), functional status (Barthel Index - BI) were recorded (November 2014 to February 2015). Frailty status (FI) was measured by an index (Rockwood) of accumulated deficits, giving a potential score from 0 (no deficits) to 1.0 (all 40 deficits). The outcomes were compared with the previous OAMH liaison service data over the same period in 2014 (November 2013 to February 2014). Ethical approval was not required for this service evaluation; however, all questions and forms required to carry out the study were sent to the research and development (R & D) department, to assess risks to patient identification and the health board. Outcome/Results: The RAID has assessed 339 patients as compared to 179 by OAMH over the same period, 100% acute admissions were assessed within 4 hours and 93% in-patient referrals were attended within 24 hours target from the time referral was received by the team. The descriptive analysis studied for 263 patients is shown below: The outcome analysis was done for 339 patients. The direct discharges from front door were increased by 7%. The mean LoS has fallen from 35 to 20 days in RGH and from 108 to 47 days in long-stay wards. The cost benefits were done based on the mean reduction in LOS (41.8 days) and admission reduction (2.2 days), making total annualised bed saving of 44 days. Conclusion(s): Prompt mental health assessments for acutely unwell frail older people are not only cost effective but also improve clinical outcomes (Table presented).