SHM Converge Scientific Abstract ePoster Gallery-Improving Care for Patients With Medical and Psychiatric Needs

Pdf Summary

This retrospective study examined trends in hospital medicine patients with significant psychiatric and behavioral needs at UCSF Health from January 2018 through October 2023. The goal was to understand how often these patients were admitted, how much inpatient resource use they generated, and whether the creation of the Code Care team in 2021 changed consultation patterns.<br /><br />The analysis found that the number of hospital medicine patients on a psychiatric hold rose substantially from 153 in 2018 to 281 in 2022, an 84% increase. These patients had a much longer average length of stay than the overall hospital medicine population, with average LOS roughly 73%–105% higher. As a result, total bed days for patients on psychiatric hold increased from 1,836 in 2018 to 5,227 in 2022, reflecting a 2.8-fold rise in inpatient utilization. The number of patients on hold with extremely long stays (over 100 days) also increased from 3 to 13 during this period.<br /><br />After Code Care was introduced in 2021, the number of patients with both a psychiatry consult and a Code Care consult increased from 71 in 2021 to a projected 204 in 2023. This suggests growing demand for specialized trauma-informed behavioral support.<br /><br />Overall, the study concludes that hospital medicine is caring for increasing numbers of patients with complex psychiatric comorbidities and behavioral needs, and that these patients consume disproportionately high inpatient resources. In response, UCSF Health is pursuing a behavioral care unit, additional staff training in de-escalation and trauma-informed care, and possibly a Behavioral Emergency Response Team.

Asset Subtitle

Smitha Ganeshan

Meta Tag

Author List Bradley Monash, Michelle Mourad, Nerys Benfield, Smitha Ganeshan

Category Research

Concept Hospital Medicine

Concept Psychiatric Hold

Concept Length of Stay

Concept Psychiatry Consultation

Concept Code Care Team

Distinguished Non-Finalist

Presenter Organization Ucsf

Presenting Author Smitha Ganeshan

Track Quality Improvement

Keywords

hospital medicine

psychiatric hold

inpatient resource use

length of stay

UCSF Health

Code Care

psychiatry consult

behavioral needs

trauma-informed care

behavioral care unit

Hospital Medicine

Psychiatric Hold

Length of Stay

Psychiatry Consultation

Code Care Team