Question

How can we quickly (preferably within 72uur) respond to a crisis situation, whether or not referring quickly and dealing efficiently with doctors hours?

Problem description

As a team it is almost impossible to respond quickly and efficiently because of the lack of available psychiatrist time. Indeed, there is a minimum of psychiatrist time because psychiatrists are expected to intervene, mainly because of medico-legal reasons (control). This minimum is impracticable for our team, and by consequence a vacuum of responsibility occurs.  Psychiatrists do not make home visits due to time constraints, psychiatric consultation takes place in our offices  (the patient must come to us).  There’s often one week between intake and consult. There is too little time to discuss the weekly current files.  Mostly, there is only time to discuss intakes and problem situations, mostly 2 to 3 days later as needed, which makes that treatment plans remain limited or are delayed

Impact - effect

Frustration, both for the doctors and team members because we can’t respond to expectations and goals regarding meetings and consultations.  In addition, on a regular basis we have the impression that a more rapid response than the current one, is possible.

The responsibility to include a person and to start up an intervention by the mobile team, remains with the doctor, based on the intake by team members.  Yet, the doctors want to meet the client, although the intakers are convinced that the referral is justified. This causes an extra cost: more home visits and administration time and a consult with the doctor (while psychiatrist time is already limited)

To do

To do: the doctor is present at the intake so that decisions (starting up an intervention by the team, or direct referral) are made based on his point of view.  This would also allow direct prescriptions of the necessary medical support, which can be a great added value with some problems such as psychotic disorders

Theme

Role of psychiatrists

Topic

Number of hours/week available for the team, number of WTE psychiatrist (full-time, part-time..)

Reference -  contact

Brecht Aerts, Kathleen Schols

Mobile team

2a

Project

Noolim

Intership abroad - place

Birmingham (Oleaster Home Treatment)

Date

October 2014