Comparison of consultation–liaison psychiatry services for inner-city, district or regional general hospitals using a common tool: Does one size fit all?

• Routine measurement of activity and outcomes in CL psychiatry is uncommon.
• Liaison services see similar patients and perform similar roles across locations.
• A tool for CL data collection (referrals and activity) was applicable across sites.
• Timeliness of CL response depends upon sites covered, workload and staff resources.
• Measuring referral rates and response times may assist resource allocation in CL.

ObjectiveConsultation–liaison psychiatry (CLP) services vary in terms of structure, function and responsiveness. It is not known whether evaluation measurements can be meaningfully compared across different CLP services to assess value and efficiency. The aim was to develop and test a common tool for measuring process and outcome measures in CLP.MethodsA data collection tool was developed using the literature and consultation with CLP clinicians. The tool was used to prospectively gather referral data, response times, health utilisation data and functional outcomes for individuals referred over seven months to three different CLP teams, servicing inner city, district and regional areas.ResultsThe structure, staffing, liaison attachments and scope of practice varied between the services. The regional CLP service attended seven hospitals and had the highest referral rate and largest inpatient population pool. The three services received referrals for similar reasons and made similar diagnoses. Multimodal management was the norm, and CLP facilitated follow-up arrangements upon discharge. Only the district CLP service saw all emergency referrals within an hour. Age and need for an interpreter did not affect response times.ConclusionDespite local differences in geography, CLP roles, hospital and community mental health service pathways and patient populations, the CLP data collection tool was applicable across sites. Staff resourcing and referral demand are key determinants of CLP response times.