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Type: Journal article
Title: Implications of bed reduction in an acute psychiatric service
Author: Bastiampillai, T.
Bidargaddi, N.
Dhillon, R.
Schrader, G.
Strobel, J.
Galley, P.
Citation: Medical Journal of Australia, 2010; 193(7):383-386
Publisher: Australasian Med Publ Co Ltd
Issue Date: 2010
ISSN: 0025-729X
1326-5377
Statement of
Responsibility: 
Tarun J Bastiampillai, Niranjan P Bidargaddi, Rohan S Dhillon, Geoffrey D Schrader, Jörg E Strobel and Philip J Galley
Abstract: Objective: To evaluate the impact of psychiatric inpatient bed closures, accompanied by a training program aimed at enhancing team effectiveness and incorporating datadriven practices, in a mental health service. Design and setting: Retrospective comparison of the changes in services within three consecutive financial years: baseline period — before bed reduction (2006–07); observation period — after bed reduction (2007–08); and intervention period — second year after bed reduction (2008–09). The study was conducted at Cramond Clinic, Queen Elizabeth Hospital, Adelaide. Main outcome measures: Length of stay, 28-day readmission rates, discharges, bed occupancy rates, emergency department (ED) presentations, ED waiting time, seclusions, locality of treatment, and follow-up in the community within 7 days. Results: Reduced bed numbers were associated with reduced length of stay, fewer referrals from the community and subsequently shorter waiting times in the ED, without significant change in readmission rates. A higher proportion of patients was treated in the local catchment area, with improved community follow-up and a significant reduction in inpatient seclusions. Conclusion: Our findings should reassure clinicians concerned about psychiatric bed numbers that service redesign with planned bed reductions will not necessarily affect clinical care, provided data literacy and team training programs are in place to ensure smooth transition of patients across ED, inpatient and community services.
Keywords: Humans; Length of Stay; Patient Discharge; Patient Readmission; Retrospective Studies; Follow-Up Studies; Mental Health Services; Hospital Bed Capacity; Psychiatric Department, Hospital; Quality of Health Care; Australia; Catchment Area, Health
Rights: © The Medical Journal of Australia 2010
RMID: 0020101404
DOI: 10.5694/j.1326-5377.2010.tb03963.x
Appears in Collections:Psychiatry publications

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