Incomplete Information, Incomplete Care: A Retrospective Analysis of Psychiatric Consultation Requests

Abstract

Objective:
When requesting a consultation from the Consultation-Liaison Psychiatry (CLP) unit, it is crucial to provide sufficient patient information to ensure timely access, accurate understanding of both physical and psychiatric conditions, and appropriate intervention. This study aimed to evaluate the content of written notes by physicians when referring patients to psychiatry for consultation.

Method:
A checklist was developed based on the minimum information expected in a psychiatric consultation request. Using this form, a retrospective review was conducted of patient records referred to psychiatry from inpatient wards and the emergency department at Pamukkale University Faculty of Medicine Hospital between January and May 2017.

Results:
A total of 725 consultation requests were analyzed. Inpatient diagnosis was not documented in 49% (n=355) of requests, and the reason for hospitalization was missing in 45% (n=326). Comorbid medical conditions were not reported in 96.1% (n=697), and current medications were not mentioned in 97.4% (n=706). Psychiatric symptoms were not described in 41.9% (n=304) of the notes. In 56.1% (n=407) of cases, the reason for the consultation was not specified. Additionally, 21.9% (n=159) of the requests included abbreviations that could hinder understanding.

Conclusions:
Findings suggest that many consultation requests fail to clearly communicate the patient's status and the consulting physician's expectations. The content and clarity of referral notes are essential for effective psychiatric assessment and interprofessional collaboration. Contributing factors may include physicians' working conditions, the increasing specialization within medicine that challenges holistic training, and general knowledge gaps regarding psychiatric consultation practices.