Improving Liaison Psychiatry Referral Efficiency: A Quality Improvement Project in Liaison Psychiatry Services
A. Iordache, M. Keenan, A. Tarar, A. Landers, I. PozerskiIntroduction
Prior to intervention, psychiatry referrals were paper-based and team-specific, resulting in several recurring issues. These included difficulty contacting referrers for missing information, misplaced or lost referrals, and delays in processing due to physical forms sitting unattended. The use of separate forms for General Adult and Psychiatry of Old Age created further confusion, with inappropriate referrals commonly made to the wrong service due to unclear triage criteria. There was also no reliable way to confirm when a referral had been submitted or received.
Objectives
To streamline the referral process by implementing a unified email-based system and assess its impact on referral accuracy, accountability, and response time.
Methods
A quality improvement intervention was implemented to address six recurring problems: 1) Difficulty contacting the referrer to clarify missing or incomplete information, 2) Misplaced or lost referrals, 3) Incorrect referral forms used due to service-specific templates, 4) Unclear criteria for General Adult vs. Psychiatry of Old Age referrals, 5) No tracking or acknowledgment system, and 6) Duplicate referrals for follow-up under the same admission due to lack of visibility. A unified referral system using a single dedicated email address and merged referral form was introduced. We collected baseline data for one month pre-intervention and compared it to data from one month post-intervention. Metrics assessed included referral volumes and processing improvements.
Results
Referrals remained stable overall (62 before, 64 after), with significant process improvements noted. Referrals seen within 24 hours rose from 29 to 35, and those exceeding 72 hours dropped from four to zero. Although a few referrals were submitted without attachments, this was resolved via email follow-up. Average response time improved from 30.6 to 24.4 hours. Table 1 summarizes referral volumes; Table 2 outlines measurable process improvements. Figure 1 displays the response time shift.