Clinical update and commentary on psychiatric care for patients experiencing workplace bullying.

OBJECTIVE: To provide a brief clinical research update and commentary advice on the practical psychiatric care of patients suffering workplace bullying. CONCLUSIONS: While there is empirical research on the prevalence and impacts of workplace bullying, there is a relative dearth of clinical research into psychiatric patient care. Accordingly, we provide commentary on practical considerations that assist in psychiatric care planning and delivery.

Implications of bed reduction in an acute psychiatric service.

OBJECTIVE: To evaluate the impact of psychiatric inpatient bed closures, accompanied by a training program aimed at enhancing team effectiveness and incorporating data-driven practices, in a mental health service. DESIGN AND SETTING: Retrospective comparison of the changes in services within three consecutive financial years: baseline period - before bed reduction (2006-07); observation period - after bed reduction (2007-08); and intervention period - second year after bed reduction (2008-09). The study was conducted at Cramond Clinic, Queen Elizabeth Hospital, Adelaide. MAIN OUTCOME MEASURES: Length of stay, 28-day readmission rates, discharges, bed occupancy rates, emergency department (ED) presentations, ED waiting time, seclusions, locality of treatment, and follow-up in the community within 7days. RESULTS: Reduced bed numbers were associated with reduced length of stay, fewer referrals from the community and subsequently shorter waiting times in the ED, without significant change in readmission rates. A higher proportion of patients was treated in the local catchment area, with improved community follow-up and a significant reduction in inpatient seclusions. CONCLUSION: Our findings should reassure clinicians concerned about psychiatric bed numbers that service redesign with planned bed reductions will not necessarily affect clinical care, provided data literacy and team training programs are in place to ensure smooth transition of patients across ED, inpatient and community services.