Psychiatric Patients Boarding at the Emergency Department: Length of Stay and Consequences

Objectives: In this research audit we look at the length of stay for psychiatric patents boarding at the emergency room at HamadGeneral Hospital which is the largest government hospital in the state of Qatar.We also looked at other parameters like, the number of psychiatric patients who leave the ER against medical advice of their ownwill, whether they return afterwards within a week or not, and also, how many of the boarding patents were treated and dischargedwithout being transferred to the psychiatry hospital.Significant Findings: It was found that out of the 357 boarding patents, only 95 (26.6%) spent less than 12 hours in the ED, anda cumulative of 115 patents spent more than 24 hours in the ED. What was also found was that from the 65 patents discharged ythe psychiatry liaison team only 3 returned to the ED within 1 week.Principal Recommendations: To find a safer alternative to patients boarding in the emergency room, in the form of increasedin patent beds in Psychiatry, increased flow to community services in additon to adequuate staffing and ER resources includingstaff and doctors to care for the boarding patents.Conclusion: After reviewing the national mental health strategy, as mentioned in the introduction as well, it is deemed that a needof 319 psychiatric beds is present in the state of Qatar currently. The mental health strategy also highlights plans for expansion ofpsychiatric services in all the various disciplines like community and home care as well, in order to reduce the number of patentsboarding in the ER which goes in line with the recommendations that are produced through this audit.