Reducing unnecessary psychiatric consultations for informed consent by liaison with administration

F. Patrick McKegney, Bruce J. Schwartz, Mary A. O'Dowd

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

The frequency of a psychiatric consultation being requested to assess a patient's capacity to give informed consent varies among institutions, with most recent surveys reporting a frequency of between 3% and 8% of all consultations. At Montefiore Medical Center, a hospital policy was interpreted as mandating such consultations for all patients with possible or even definite lack of decisional capacity. From 1987 to 1988, 55% of all psychiatric consultations in the institution were for consent. Only 9% of the consent patients seen had an Axis I diagnosis other than organic mental syndrome (OMS). Because many of these consultations were believed to be unnecessary, with the patient clearly able or unable to give consent, the consultation service worked first with administration to modify the guidelines, and then educated the medical and nursing staff as to when consultation was indicated. With this program, the number of consent consultations fell from 958 in 1988 to 177 in 1990, representing a major saving of staff time and thirdparty billings. In this era of cost containment and outside review of professional practices, psychiatrists must take responsibility for identifying areas where patient services and billings for them are not justified by clinical indications.

Original languageEnglish (US)
Pages (from-to)15-19
Number of pages5
JournalGeneral Hospital Psychiatry
Volume14
Issue number1
DOIs
StatePublished - 1992

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Informed Consent
Psychiatry
Referral and Consultation
Professional Practice
Cost Control
Nursing Staff
Medical Staff
Guidelines

ASJC Scopus subject areas

  • Medicine(all)
  • Emergency Medicine
  • Psychiatry and Mental health

Cite this

Reducing unnecessary psychiatric consultations for informed consent by liaison with administration. / McKegney, F. Patrick; Schwartz, Bruce J.; O'Dowd, Mary A.

In: General Hospital Psychiatry, Vol. 14, No. 1, 1992, p. 15-19.

Research output: Contribution to journalArticle

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