Communication pathways from the emergency department to community mental health services: A systematic review.
Heather McIntyre, Verity Reeves, Mark Loughhead and 2 others
PMID 35598319WHAT IT FOUND
Support coordination and electronic record alerts improved follow-up links, but phone calls alone did not.
The largest trial found no significant reduction in emergency re-presentations. Evidence is sparse, with few studies including patient perspectives.
Key findings
01Support coordination interventions increased linkage to primary care (62.4% vs 37.6%) but did not significantly reduce emergency department re-presentations in the largest trial.
02An electronic record strategy increased communication to primary care physicians from 1% to 40% and reduced repeat presentations within 4 weeks from 4% to 0.5%.
03Telephone follow-up alone failed to improve attendance significantly, as 83% of adolescents attended appointments without prompting in the control group.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only three studies elicited lived experience perspectives, and only one included a researcher with lived experience. The number of included studies was small (seven), limiting the strength of conclusions. Interventions were heterogeneous, preventing meta-analysis. Some studies had small sample sizes, particularly the pilot randomized controlled trials. The review excluded studies involving inpatient admissions, limiting generalizability to patients who require hospitalization.
Declared interests
The authors declared no conflicts of interest. The research team included a lived experience researcher and a lived experience carer.
The easy way to misread this
Do not assume that telephone follow-up alone reduces emergency re-presentations. The largest trial found no significant reduction, and phone-only interventions showed minimal benefit when baseline attendance was already high.