An evaluation of referral tickets for acute psychiatric admissions

Abstract

Background Tickets of referral assist in clerking and the enforcement of the Mental Health Act. Initial reviewers of the patient who may be more aware of his/her background may provide this information when transferring a patient to Mount Carmel Hospital, Malta’s psychiatric hospital. Objectives The aims of this study were to assess whether key information on referral tickets was lacking as well as to justify the importance of such information when referring a new case and raise awareness on appropriate referral. Methods Permission to review the tickets of referral for new admissions from the community to Mount Carmel Hospital during the month of June 2015 was obtained from the Chairman of Psychiatry. The files of new admissions were assessed to see if the following were present: official referral ticket; drug history; next of kin details; handover to staff at Mount Carmel Hospital. The place of initial assessment was also noted. All data was anonymised and data input was done using a prepared proforma. Patients referred from the civil prison and by the caring consultant’s firm were not included. Results Seventy admissions were assessed. Eighty-nine per cent (n=62) of these admissions included an official ticket of referral. Most referrals came from health centres: 31% (n=22). Seventy-four per cent (n=51) had a drug history present. Seventy-six per cent (n=53) were lacking next of kin details. Forty per cent (n=28) of the cases had documentation of a handover to a senior on call. Conclusions Poor quality referral tickets with missing information are often present which makes it difficult for the on-call staff at Mount Carmel Hospital to clerk the patient and come up with a provisional treatment plan.