Effects of Clinical Practices Guideline for Triage Emergency Psychiatric Patients on Clinical Outcomes in Emergency Psychiatric Department Suan Prung Psychiatric Hospital, Chiang Mai Province

Abstract

Violent behavior problems in society are increasing. According to statistics from the Ministry of Public Health’s health database system, patients with a high risk of violence have received services from 2016-2022, totaling 27,518 people. Approximately 3 percent of the violent individuals were patients diagnosed with psychiatric disorders and drug abuse. In order for psychiatric patients to receive services quickly, correctly, and safely in emergency psychiatric work, patients must be correctly and appropriately triaged to classify service recipients and prioritize emergency patients to receive emergency medical services in order of emergency medical urgency. This study aimed to improve, evaluate, and compare the correct triage rate before and after implementing the Suan Prung emergency psychiatric triage (SPEPT) guidelines for emergency  psychiatric patients at Suan Prung Hospital, Chiang Mai Province. It was conducted as a prospective implementation study. The samples consisted of 3 groups: (1) 8 personnel from the team that improved the emergency psychiatric patient triage guidelines; (2) 20 personnel who used the emergency psychiatric patient triage guidelines; and (3) 500 emergency psychiatric patients who received emergency psychiatric services. The original psychiatric patient triage guidelines, namely the 2021 Suan Prung Hospital emergency psychiatric triage guidelines, were used in July 2024, totaling 250 patients, and the newly revised Suan Prung Hospital emergency psychiatric triage (SPEPT) in August 2024, totaling 250 patients. It was

found that: (1) assessment of the accuracy of screening patients screened using the original triage guidelines, there were 137 correct screenings out of 250 patients, or 54.80 percent, and there were 113 incorrect screenings out of 250 patients, or 45.20 percent. As for the accuracy of patient screening using the revised emergency psychiatric triage form, there were 204 correct screenings out of 250 patients, or 81.60 percent, and 46 incorrect screenings out of 250 patients, or 18.40 percent. (2) The accuracy ratio of screening between patients screened using the original screening form and patients screened using the revised emergency psychiatric triage form found that patients screened using the revised emergency psychiatric triage form had a significantly higher screening accuracy ratio than those screened using the original screening form (p<0.001). (3) The results of the implementation of the emergency psychiatric triage guidelines found that most psychiatrists and nurses followed the guidelines correctly. (4) The results of the study on the satisfaction of personnel who used the guidelines found that the overall satisfaction was at the highest level, with the mean score of 3.85 (SD=0.37).