5 | P a g e
Evidence Informed Practitioner and Organisation Social Work Module
(SWK 751)
Title of Systematic
Narrative Review
Alternatives to Acute Admission for Patients with a
Primary Diagnosis of Emotionally Unstable
Personality Disorder
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 (EUPD).
Crisis services in Belfast for this cohort of patients is very limited and previous
research demonstrates that an acute hospital admission can be
counter-productive. Therefore, this literature review was undertaken to inform
]the development of crisis services for EUPD within the Belfast Trust.
Methods employed in the review:
Search Strategy:
The proposed databases for this literature review are
• Social Care Online,
• Scopus and
• PsycInfo.
Literature before 2013 is in the exclusion criteria. This
complements the introduction of the 'You in Mind' strategy, is in line with the
recommendations from the Bengoa Report in 2016 and ensures only the most
recent literature is reviewed.
Method of Data Extraction: