Administrative errors could be responsible for
over half of patients with mental health problems failing to turn
up for their hospital appointments, a study conducted in Belfast
has shown.
According to the research, which was presented
today (Friday, 4 July) at the Royal College of Psychiatrists’
Annual Meeting, a substantial minority of these patients suffer
from severe mental health disorders and may be at risk of
suicide.
Dr Ashling O’Hare, a specialist registrar in
adult psychiatry at the South Eastern Health and Social Care Trust,
Belfast, Northern Ireland, and colleagues, used the hospital IT
system to identify all the patients – some 352 – who had been
recorded as ‘open’ on the caseload of a single consultant
psychiatrist. These patients had not been issued with an outpatient
appointment for over a year.
The researchers analysed the reasons for this
‘loss of follow-up’ in 69 of the patients. They found that in 52
per cent of the cases, administrative mistakes were the main reason
for patients not turning up for their appointments.
In half of the cases where administrative
errors had occurred, a clinical decision to discharge the patient
had not been recorded on the IT system. In the other half, no
further appointments had been generated despite the need for this
being indicated as part of the management plan.
Indeed, in 35 per cent of the cases, the onus
to arrange a further appointment had been placed on the patient,
despite the fact that 12 per cent of them had severe mental
illness. In two thirds of the cases, some level of risk – usually
of suicide – was identified.
The authors concluded that it is unacceptable
for patients to become lost to follow-up because of system errors.
Documentation of clinical decisions is crucial, they said. An
effective administrative system and policy for dealing with
patients who disengage from services are vital components of the
governance system required to manage risk.
For further information, please contact Liz Fox or Deborah
Hart in the Communications Department.
Telephone: 020 7235 2351 Extensions. 6298 or 6127
References:
The Annual Meeting of the Royal College of Psychiatrists, Imperial College, London, 1 – 4 July 2008