Nurse-led liaison mental health service for older adults: service development using lean thinking methodology.

OBJECTIVES: Liaison Psychiatric Services for Older Adults in the UK have been established over the last decade, with rather divergent team composition and involvement. The latest documents (National Dementia Strategy, Who Cares Wins) set the gold standard for liaison services for older adults in England, requiring a proactive approach to services and integrating assessment and treatment of mental disorder into routine general hospital practice. This requires a physical presence of liaison services in the hospital, with collaboration with medical colleagues. METHODS: We have adopted the above strategy in a nurse-led liaison service working in a General District Hospital, and used the Toyota Production System. RESULTS: In the current study we reflect on the 5 day rapid progress improvement workshops event for the liaison branch of the project, and describe the process of identifying real situation problems for the care of the medically ill, the involvement of the liaison team in their clinical care, and a feedback on the change in practice. CONCLUSION: The novel approach of identifying areas for change in an ongoing nurse-led Liaison service for Older Adults resulted in improving access to mental health services for elderly medically ill inpatients and improved quality of their overall care.

Practice question.

This is an interesting and important question of national concern. Responses to the consultation on the Chief Nursing Officer's Review of Mental Health Nursing ( Department of Health 2006 ) and the Royal College of Psychiatrists' ( 2009 ) report noted that people with mental health problems often receive less than adequate care for their physical health. Physical health problems, particularly chronic health problems such as obesity, diabetes and smoking-related illnesses, are more common in people with long-term mental illness.