AB227. 177. Orthopaedic—liaison psychiatry quality improvement project

Background: At Barnet Hospital, anxiety/depression is the most common reason for referral of orthopaedic patients to Liaison Psychiatry. Both depression and anxiety are predictors for poor adherence with physiotherapy, I and the physiotherapists reported significant issues with poor engagement. Average hospital stay for fractured neck of femur patients with anxiety/depression was 30 days (for those referred to Liaison Psychiatry), compared with the department average of 15 days (last 2 years’ data). This project focuses on improving their engagement with physiotherapy in order to reduce length of stay, hospital-acquired infections and help the department to tackle bed shortages.

Methods: The project included: Training of the physiotherapists and occupational therapists by the Liaison Psychiatry team, designing a poster, implementing a system for highlighting these patients in MDT meetings.

Results: Occupational therapists and physiotherapists now report being better able to identify these patients and deploy techniques to improve engagement. The intervention is being expanded to three further wards and we are monitoring the outcomes to ensure that intervention translates into improved clinical outcomes.

Conclusions: This project tackled an important aspect of post-operative care that was not being effectively addressed. It is low cost, easily replicable, and offers considerable benefits for length of stay.

Keywords: Orthopaedic; surgery; liaison psychiatry; bedstay