Missed Serious Medical Illness in Psychiatric Patients Seen in an Academic Emergency Department

Emergency Services, Psychiatric Clinical Trial

Official title:

Missed Serious Medical Illness in Psychiatric Patients Seen in an Academic Emergency Department

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT02581267
• Other study ID #: 107073
• Status: Active, not recruiting
• Phase: N/A
• First received: August 8, 2015
• Last updated: October 19, 2015
• Start date: October 2015
• Est. completion date: December 2015

Study information

• Verified date: October 2015
• Source: Western University, Canada
• Contact: n/a
• Is FDA regulated: No
• Health authority: Canada: Ethics Review Committee
• Study type: Observational

Clinical Trial Summary

Psychiatric presentations are common in the emergency department (ED), and determining whether or not a psychiatric presentation is due to medical illness can be a difficult task for the emergency physician. The investigators define "serious medical illness" (SMI) as a pathological condition that would necessitate inpatient treatment on a medical or surgical ward. It is important for patient safety that SMI be triaged by the emergency physician to the appropriate inpatient service. The rate of missed SMI in patients with psychiatric presentations to the ED is unknown. The investigators will research missed SMI in patients referred to adult psychiatry from the ED, with the intent to improve patient safety.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 800
• Est. completion date: December 2015
• Est. primary completion date: December 2015
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• All patients greater than or equal to 18 years of age presenting to London Health Sciences Centre, Victoria Hospital emergency department between October 1, 2014 - July 31, 2015 who were referred to adult psychiatry by the emergency physician.

Exclusion Criteria:

Study Design

Observational Model: Cohort, Time Perspective: Retrospective

Related Conditions & MeSH terms

• Emergencies
• Emergency Services, Psychiatric

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Western University, Canada

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of patients admitted to a medical / surgical service within 7 days of psychiatry referral in the emergency department		Approximately 8 months	No
Primary	Medical / surgical admission diagnosis	This will be extracted from the electronic medial record.	Approximately 8 months	No
Primary	Number of days after psychiatric referral that patient is admitted to medical / surgical service		Approximately 8 months	No
Secondary	Proportion of patients discharged home from the emergency department by psychiatry following referral by the emergency physician		Approximately 8 months	No
Secondary	Risk factors associated with medical / surgical admission after initial psychiatry referral	The investigators will be extracting variables from the patient's chart including triage vital signs, past medical and psychiatric history, initial laboratory bloodwork, and determining if any of these are risk factors for subsequent medical / surgical admission.	Approximately 8 months	No
Secondary	Number of admissions to medical / surgical service within 30 days of discharge from psychiatry		Approximately 8 months	No