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Analysis of Transfers From a Medical-Psychiatry Inpatient Unit to a Medical-Surgical Unit Within 48 Hours of Admission

Received February 1, 2007; revised August 27, 2007; accepted September 6, 2007. From the Dept. of Psychiatry, Mayo Clinic, Rochester MN. Send correspondence and reprint requests to Victoria Passov, M.D., Dept. of Psychiatry, Mayo Clinic, 1115 2nd St. NW, Rochester, MN 55901. e-mail: passov.victoria{at}mayo.edu
© 2008 The Academy of Psychosomatic Medicine

BACKGROUND: Clinical screening of patients being presented for admission to a medical-psychiatric unit (MPU) is important to ensure safe, timely, and effective treatment. OBJECTIVE: Authors determined demographic and clinical characteristics of patients accepted for admission to a private MPU and who required transfer to medical-surgical units within 48 hours of admission. METHOD: Medical records of 1,583 consecutive admissions to the MPU were reviewed. The charts of patients transferred to a higher level of medical or surgical care within 48 hours were evaluated to categorize the reasons for transfers, and these were assessed for preventability. RESULTS: Thirty patients (1.9%) required transfer to a medical-surgical unit. Reasons for transfer included pulmonary, cardiovascular, endocrine, and neurological etiologies. Most transfers (66.6%) were not foreseeable because symptom-onset was after admission. CONCLUSION: Inappropriate MPU admissions may have been avoided by more vigilant screening for pulmonary, cardiovascular, electrolyte, and infectious disorders.

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