# A Mixed-method Study on the Implementation of a Medical Psychiatric Care Unit

## TL;DR

This study examines how a medical psychiatric unit at Erasmus MC is used and evaluated by physicians, finding it meets goals for integrated care and patient management.

## Contribution

The study provides new insights into physician perspectives and referral patterns for Medical Psychiatry Units (MPUs).

## Key findings

- Physicians report improved care quality, job satisfaction, and reduced stigmatization with the MPU.
- MPU admitted nearly twice as many disruptive patients compared to PCS referrals.
- Common MPU referral reasons included nursing care load, department expertise, and suicidality.

## Abstract

Medical Psychiatry Units (MPUs) offer integrated care for patients needing both medical and mental healthcare in hospitals. MPUs provide unique care not covered by Psychiatric Consultation-Liaison Services (PCS). Despite their increasing number, little research exists on why referrers choose MPUs, though their perspectives shape patient populations and reflect MPU goals.

1. Asses physician satisfaction with the Erasmus Medical Center MPU and its alignment with initial expectations.2a. Evaluate whether referrals match the intended patient population needing disruptive behavior management and compare this with PCS referrals.2b. Identify unintended reasons for MPU referrals.

1. Asses physician satisfaction with the Erasmus Medical Center MPU and its alignment with initial expectations.

2a. Evaluate whether referrals match the intended patient population needing disruptive behavior management and compare this with PCS referrals.

2b. Identify unintended reasons for MPU referrals.

We conducted interviews with physicians and analyzed questionnaires on MPU or PCS referrals from November 2020 to May 2021.

1. Physicians report that the MPU improves care quality, job satisfaction, collaboration, safety, educational value and reduces stigmatization.2a. Among 62 referrals, the MPU admitted nearly twice the disruptive patients.2b. Common MPU referral reasons included nursing care load, department expertise and suicidality, while PCS referrals were more often due to delirium.

1. Physicians report that the MPU improves care quality, job satisfaction, collaboration, safety, educational value and reduces stigmatization.

2a. Among 62 referrals, the MPU admitted nearly twice the disruptive patients.

2b. Common MPU referral reasons included nursing care load, department expertise and suicidality, while PCS referrals were more often due to delirium.

The Erasmus MC MPU meets its founding goals. Physicians recognize its added value, particularly in managing patients with disruptive behaviors and high care needs. The integration of medical and psychiatric expertise has fulfilled expectations.