Developing simulated training in old age psychiatry to recognise and assess medical problems in a psychiatric setting (RAMPPS)

Abstract

Introduction Older people with mental ill health are more likely to receive lower quality of health care, inappropriate prescriptions and reduced access to services, leading to increased rates of mortality [1-3]. There is increase focus on supporting people with multiple long-term physical and mental health conditions, particularly by embracing opportunities created by technology [4] (references are not available for this abstract). Objectives To identify the common medical comorbidities on the Old Age Psychiatry Wards. Aims To develop simulation training from the medical scenarios. Method We audited all patients referred to the Liaison Geriatrician from 2008 to October 2015 from the Mount Hospital Leeds, which consists of 4 Old Age Psychiatry wards. Data was collected in October 2015 and included referral date, patients' age and sex, number of referrals, reason for referral and the outcome. Results We assessed 339 (142 F, 197 M) patients with a mean age of 77 (range: 56-94). The cardiovascular problems constituted the majority (34%) of the referrals, central nervous system (11%), respiratory (8%), gastrointestinal (8%), infection (8%), musculoskeletal (7%), renal (3%), others (19%) and the reasons were unknown in (2%) of the 440 referrals. Some unusual problems were diagnosed including a spontaneous pneumothorax, primary biliary cirrhosis. Conclusion The audit highlights the essence for more training in recognising and assessing medical problems in psychiatric settings - the simulation programme (RAMPPS) in Old Age Psychiatry. As a result of the service model, we are developing a simulation-training course tailored to the mental and physical health needs of the elderly.