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Morgan, Are CRHT teams seeing the patients they are supposed to? (2007)
Key function B: Supporting early discharge (x22)
This function is performed by CRHT teams that are able to discharge patients from inpatient wards and take-over their care at home or in the community. The discharge is earlier than it otherwise would be because the patient is still in a psychiatric crisis but is able to be better treated at home and so is discharged into the care of the CRHT team. Some managers said this function was supported by daily/weekly review meetings, support from the inpatient staff, and sharing medical staff across the inpatient and CRHT teams; but others reported the function was hindered by an over-use of ward leave, poor understanding of the function by Consultant Psychiatrists, insufficient social services delaying some discharges, and where there was a physical distance between the inpatient and CRHT teams. (p.5-6)
Chapter 5: CRHT teams are facilitating earlier discharges where the ward and CRHT team are integrated, but there is room to improve performance in this area
1. The term 'early discharge' means discharge earlier than would have happened if intensive home treatment was not available. If a patient is discharged to the CRHT team they are expected still to be in crisis and hence in need of acute care, but this care is judged to be most appropriately provided at home, enabling the discharge from hospital. The discharge is earlier than otherwise would occur - in a 'normal' discharge the crisis would have resolved and the patient could be discharged to CMHT for non-acute supervision.
CRHT teams are engaged in around half of discharges, with the likely result that the discharge is earlier than it would otherwise be.
CRHT and Ward staff had conflicting information regarding the discharge status of around one admission in every eight.
CRHT teams with a strong gatekeeping function were more likely to be involved in discharges. (p.41-47)