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Title of study
Alternatives to Acute Admission for Patients
with a Primary Diagnosis of Emotionally
Unstable Personality Disorder - Staff
Perspectives
Abstract
Context:
A Quality Improvement initiative was commenced in Acute Mental Health
Inpatient Centre in March 2020 at the start of the Covid-19 pandemic to try and
assist with discharging people out of acute care in line with government
guidelines at the time. A strategy was devised to reduce the numbers of patients
who were classed as 'delayed discharges' in the system. While scrutinising these
patients' circumstances, a cohort dubbed 'revolving door' admissions were
incidentally identified. This prompted a further Quality Improvement initiative to
endeavour to understand why these patients had a number of frequent
admissions and how community services could be tailored to better meet their
needs, and attempt to reduce pressure on demand for acute hospital beds.
Inclusion criteria for the project was any patient who had been admitted twice
within a 12-month period. Upon scrutiny of these patients it was discovered that
a high proportion of them had a primary diagnosis of Emotionally Unstable
Personality Disorder.
Crisis services in the Trust for this cohort of patients is limited and previous
research demonstrates that an acute hospital admission can be counterproductive.
A literature review was undertaken to inform the development of
crisis services for Emotionally Unstable Personality Disorder (EUPD) within the
Belfast Trust. Following the literature review qualitative research was completed
with the staffing group in acute inpatients to elicit their views on providing front
line care for this group, and their professional opinions on the planning of care in
the future in relation to the Mental Health Strategy.