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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Use of a capacity audit tool in a mental health setting

Kathryn Zeitz A and Paul Hester B C
+ Author Affiliations
- Author Affiliations

A Mental Health Directorate, Central Adelaide Local Health Network, Eastern Community Mental Health, 172 Glynburn Road, Tranmere, SA 5072, Australia. Email: kathryn.zeitz@health.sa.gov.au

B Royal Adelaide Hospital, Improving Care, Level 2 Margaret Graham Bld, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia.

C Corresponding author. Email: paul.hester@health.sa.gov.au

Australian Health Review 40(1) 82-85 https://doi.org/10.1071/AH15065
Submitted: 1 May 2015  Accepted: 10 May 2015   Published: 27 July 2015

Abstract

Objective This paper reports on a pilot applying the capacity audit tool (CAT) in a mental health environment and what the tool reveals regarding mental health in-patient capacity issues.

Methods The CAT was modified to create an electronic mental health-relevant tool to audit acute in-patient capacity. This tool was then piloted across nine bedded units, within a single Local Health Network, covering a total of 153 mental health beds.

Results The application of the mental health CAT resulted in 100% compliance in completion. The findings revealed that 16% (25 beds) of the 153 beds surveyed were occupied by patients who did not need to occupy the bed or the bed was vacant. Of these 25 beds, 10 had patients awaiting transfer to another facility or service, nine were empty and six were occupied by patients ready for discharge but for whom there were delays.

Conclusion The CAT was successfully applied to the mental health setting and identified a set of opportunities to improve processes and practices to reduce the identified delays or barriers in order to improve patient flow.

What is known about the topic? Capacity management and, in particular, timely discharge are key components to optimise patient flow and improve access block for emergency departments. The CAT has been successfully applied in general health settings to identify key delays and barriers to discharge.

What does this paper add? This article reports on the applicability of the CAT in a mental health setting and the ability of the tool to improve our understanding of bed capacity by identifying key reasons for the use of mental health in-patient beds across a stepped model of care and quantifying the most frequent causes of discharge delay.

What are the implications for practitioners? This paper describes the modifications of the CAT to make it applicable to the mental health setting and the associated results obtained using the CAT in a mental health setting. The project demonstrated applicability of the tool to the mental health setting. It can be used in other jurisdictions to identify key discharge delays to underpin targeted improvement work within local mental health environments.


References

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[2]  Zeitz K, Carter L, Robinson C. The ebbs and flows of changing acute capacity delays. Aust Health Rev 2013; 37 66–9.
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[3]  Haraden C. Wasted capacity audit tool. Institute for Healthcare Improvement (IHI), USA; 2006. Available at http://www.ihi.org/ihi [verified 15 November 2006].

[4]  Forero R, Hillman K. Access block and overcrowding: a literature review. Prepared for the Australasian College for Emergency Medicine (ACEM). 2000. Available at: https://www.acem.org.au/getattachment/a9b0069c-d455-4f49-9eec-fe7775e59d0b/Access-Block-2008-literature-review.aspx [verified 24 February 2015].

[5]  Government of Western Australia. The Western Australian mental health alcohol and other drug services plan (2015–2025). Available at: http://www.mentalhealth.wa.gov.au/Libraries/pdf_docs/Plan_27_11_2014_for_consultation_3.sflb.ashx [verified 16 February 2015].