Authors
Adil Ali Mubarak Ali, Pawan Koirala, Cherrie Galletly, Sebastian Alder-Price
Published in
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists. Pages 10398562261481761. Sep 06, 2026. Epub Sep 06, 2026.
Abstract
ObjectiveProlonged Emergency Department (ED) Length of Stay (LOS) for mental health patients adversely impacts bed flow. This study evaluated the Psychiatric Extended Care (PEC) model's PEC-C pathway, implemented at Lyell McEwin Hospital in June 2022, which transfers select patients to the Mental Health Short Stay Unit (MHSSU) before psychiatric review.MethodsThis retrospective audit compared ED LOS and Total LOS between "pre-PEC" (January-April 2022) and "post-PEC" (January-April 2024) cohorts meeting PEC-C criteria (voluntary patients meeting predefined safety and medical screening criteria presenting for mental health reasons). Primary outcomes were ED LOS and Total LOS (combined ED plus MHSSU LOS).ResultsIn 2022, 28/686 (4.1%) ED psychiatric referrals met PEC-C criteria; in 2024, 29/679 (4.3%) met criteria. For patients meeting PEC-C criteria, ED LOS decreased from 18.2 hours (IQR: 13.4-22.9) pre-PEC to 9.4 hours (IQR: 6.3-12.5) post-PEC (U = 102.5, p < .001). Total LOS showed no significant difference (69.4 hours [IQR: 7.3-131.5] vs 64.9 hours [IQR: 38.6-91.2], U = 406, p = 1.00). No adverse safety events occurred for patients meeting PEC-C criteria.ConclusionA significant reduction in ED LOS was observed following PEC implementation; Total LOS was unchanged. The quasi-experimental design limits causal inference, warranting prospective evaluation.
PMID:
42702584
Bibliographic data and abstract were imported from PubMed on 07 Sep 2026.
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