Original themes | Groupings |
---|---|
Role of liaison psychiatry Service development and history Diversity of work Components of liaison services organised in different ways Aims and purposes of services Types of patient problems seen by liaison services | The nature of the liaison teams |
 | Principles of Integrated Care (Suter et al., 2010) [10] |
Confusion about the referral process to liaison services Inappropriate referrals including patients with no mental health problems Onward referral and signposting | Co-ordinated transitions in care across the continuum |
Value of assessments Response to non-engagement Helping patients to manage mental health issues better via informal learning opportunities Description of the clinical process Continuing support and assessment of needs Brief interventions or follow-ups during admission Medication prescribing Preventing suicides Avoiding exacerbating long-term mental health problems Improving quality of life Improving adherence to medication for physical health problems Improving clinical outcomes for patients | Patient focused care |
Gaps in service provision Interaction with external psychiatry teams Difficulty in accessing community services | Primary care network structures in place |
Relationships with referrers Collaborative working Training and education- Influencing team members and acute service colleagues | Inter-professional team working and team effectiveness |
Notes and recording systems Time taken to record information Duplication of record keeping Absence of shared record keeping | Information systems which enhance communication capacity and information flow across integrated pathways |
Physical space and identity Problems with commissioning of liaison teams Visibility | Organisational goals and objectives aligned across sectors |
Hierarchies in mental health and acute trusts Alternative perspectives regarding training of acute staff | Physician integration within care teams and across sectors |
Reduction in length of stay Limiting time patients spent in ED Better communication with commissioners Promoting safe and efficient services-mismatch between staffing levels and volume of referrals Specialism versus generalism Influencing commissioners to expand systems Influencing mental health trust managers National models and structures Perceived prioritisation by commissioners Promoting safe and efficient services | Attainment of goals and objectives are supported by funding and human resource allocation |
What liaison services wanted to change- internal delivery processes and structures Challenges in delivering training Address mental health stigma amongst acute services colleagues Alternate persectives about training | Do not map onto a specific principle |