Abstract

SUMMARYObjectives There is little research into the constituents of effectivepsychiatric inpatient care. The aim of this study was to assess theeffectiveness of a newly adopted model of inpatient care; the acuteassessment ward.Design Review of data collected over a year-long period.Setting Acute assessment ward in North London.Participants All Admissions between 8 October 2009 and 7 October2010.Main outcome measures Duration of stay, need for readmission,patient satisfaction and frequency of conflict behaviours.Results A total of 485 admissions over the yearlong study period. Themedian stay to discharge from the assessment ward was 6 days, whereasin those transferred it was 19 days. Readmission within 28 days followingdischarge from the assessment ward was 13.9%, whereas thosedischarged from other wards was 9.2% (P=0.1). Patient satisfaction wasno lower, for all domains, than for other wards in the trust. Frequency ofconflict behaviour was equal to previous studies, 1 but self harm wassignificantly less common (P=0.01).Conclusions Our data show that focusing on the ‘point of entry’ toinpatient services means that some admission times can be reducedwithout an increase in 28-day readmission rates or conflict behaviours.The acute assessment model attempts to address the need for the NHS todeliver more for less, whilst remaining focused on service-user and staffsatisfaction. Research into which areas of this complex intervention areeffective is challenging, but we would urge others who run services withnovel structures to publish data about their functioning.