Transcript No Slide Title

Audit of Home Based Crisis Team (HBCT)-Cork City North,
Activity over a 6 month period.
Mairead Murphy, Aisling Hassett, Valerie Morrison, Martina Cullinane, Damien Fleming,
Dr. Deirdre Muller Neff, Dr Sinead O’Brien.
Background
Mode of Referral.
Time-Scale of HBCT involvement
20
15
Sector
31.2%
Percent
The Home Based Crisis Team was set up in 2007 with an
aim to provide a home based crisis assessment and multidisciplinary treatment and intervention service for
individuals presenting with acute psychiatric illness in
City North Sector. The HBCT aim to treat individuals in
the community, for approximately 4 weeks. We are
targeting adults with severe mental illness, who require
urgent assessment.
10
5
Liaison
2.4%
GP
66.4%
0
<1
<2
<3
Aims
<8
<9
>9
Admission
16.0%
3 day s or more
14.4%
Same Day
36.0%
Sector
55.2%
Not Assessed
5.6%
Methods
Reason for Referal
Suicidal
16.0%
GP
28.8%
Next Day
37.6%
Diagnosis on Discharge
Personality Dis.
7.3%
other
8.9%
Psy chosis
16.0%
Psy chosocial S
8.0%
Results
Psy chosis
13.8%
A nxiety
13.0%
BPA D
12.2%
Demographics:
▪63.2% of referrals were female.
▪77.7% of those referred lived with family while only
20.7% lived alone.
▪ The mean age of those referred was 43.2 years.
▪ 62.4% of those referred had a past psychiatric history.
Age Profile
25
20
Percent
<7
Discharge from HBCT.
2 day s
6.4%
The audit was conducted over a six month period, from
1/10/2009 to 31/03/2010. We reviewed copies of
acceptance and discharge letters of all clients assessed
during this time period using a 13 item audit proforma.
Data was analysed using SPSS version 14 and graphs
compiled using Minitab Graphics
<5
<6
Weeks
Percent within all data.
Time from Referral to assessment.
The purpose of this audit is to review the overall
procedures within the HBCT, ensuring service evaluation
and accountability. This helps identify areas for
development and recognises successful service
procedures. Thus, promoting the need for new and
creative ways of monitoring the HBCT service delivery.
<4
Relapse
60.0%
Depression
44.7%
▪ 60% of all referrals were due to
relapse of illness while suicidal
ideation and psychosis made up 16%
each.
▪ 62.4% of those referred had a past
psychiatric history.
Outcome on Discharge:
Time to Assessment
&Discharge:
Discussion
▪ 55.2% required OPD follow-up
while 28.8% were discharged
back to GP.
▪ 16% required in-patient
admission.
15
10
5
0
18-19
20-29
30-39
40-49
50-59
60-65
A ge in years
60-69
70-79
80-89
Percent within all data.
Referral:
▪ 66.4% of referrals were made by GP’s, while 31.2%
were made directly by the Sector Teams with 2.4%
being made by liaison Psychiatry.
▪77.7% of referrals were from City North West Sector.
▪36% of those referred were seen on
the day of referral with 73.6% being
seen with 24hours of referral.
▪ The mean no. of days involvement
with the HBCT was 20.04 days.
Discharge:
▪44.7% of those seen had a
diagnosis of Depression, 12.2% with
BPAD, 13.8% with Psychosis.
Acknowledgements
We wish to thank Geraldine Kenny and Martina Carroll for clerical support.
Also, Grainne Kearney and Jennifer Cuppage, Volunteer Clinical Psychology Assistants for data input.
▪ The HBCT offers an alternative
to an emergency assessment in the
acute psychiatric unit with 73.6%
being seen within 24hours of
referral.
▪ Admission rates were low for
this cohort presenting in crisis.
▪One third of those referred did
not require sector psychiatric
follow-up.