Navigating ‘Deterioration in Mental State’ – From recognition to response in general hospitals to satisfy ‘National Standards’: A Discussion paper

Abstract

Background
The Australian Commission on Safety and Quality in Health Care ‘National Standards’ require general hospitals to have systems for clinicians to recognise and respond to patients’ deteriorating mental state. The lack of an evidence-based operational definition and clear guidance challenges this requirement.

Objective
To review governance mechanisms and assessment processes for deteriorating mental state in a metropolitan general hospital and propose an organisational framework.

Methods
A qualitative document analysis using the READ approach systematically reviewed hospital committee reports, health district policies, and training programs to identify and synthesise key assessment points and processes.

Findings
The study mapped assessment points for recognising and responding to deteriorating mental state across patient journey stages. An organisational systems infographic provides a blueprint for meeting National Standards accreditation criteria.

Conclusions
Hospitals should establish comprehensive systems to observe, monitor, assess, and refer individuals with deteriorating mental state, involving multiple governance processes and frameworks.