Physical exam in mental health: implementation of a form to guide medical assessment of acute psychiatric inpatients

• Published in: Clinical audit Vol. 9; pp. 1 - 7
• Main Authors: Munshi, Tariq, Asmer, M. Selim, Penfold, Sarah, Pikard, Jennifer, Mauer-Vakil, Dane, Banwell, Emma
• Format: Journal Article
• Language: English
• Published: Macclesfield Dove Medical Press Limited 01.01.2017; Taylor & Francis Ltd
• Subjects: Analysis; Audit cycles; Audits; Bipolar disorder; Canada; Comparative analysis; Family medical history; Health aspects; Hospital patients; Hospitalists; Hospitals; Medical care; Medical examination; Medical research; Medicine, Experimental; Mental disorders; Mental health; Mental health care; Mental illness; Mentally ill; Metabolism; Outcome and process assessment (Medical care); Patients; Periodic health examinations; Physical diagnosis; Physical examinations; Physicians; Psychiatric patients; Psychiatry; Quality; Schizophrenia; Service introduction; Canada
• ISSN: 1179-2760; 1179-2760
• DOI: 10.2147/CA.S129425

The physical health of individuals suffering from mental illness is known to be diminished compared to the general population, with worse health outcomes and shortened life expectancy. This places a great burden on health care systems around the world. Due to stigma and clinician attitudes, it may be difficult for physicians to engage with mentally ill patients to screen for physical disease and implement physical health interventions. Engaging with these patients during acute inpatient admission is an ideal time to identify any specific problems that may be the focus of medical attention. The Canadian Government mandates that all patients admitted to hospital receive routine physical assessment as part of their care. Our study aimed to implement a form to guide physical screening for all psychiatric patients admitted to an acute inpatient Psychiatric Unit in Kingston, ON, Canada; the patients underwent two cycles of clinical audit between 2014 and 2015 to measure completion of forms. Although the completion rate decreased, the frequency of consultation with the hospitalist increased significantly between the two cycles. There was no relationship found between patient age, psychiatric diagnosis, and day of admission during the week did not affect completion of physical health screening. Further education and advocacy is needed to ensure appropriate screening of physical problems in patients admitted for psychiatric reasons. Future studies are needed to study the effectiveness of these forms and whether or not they are effective in improving health outcomes in the long term. Keywords: physical examination, audit, health form