Eating disorder management in acute tertiary hospitals without specialist beds: The importance of a standardised management approach.

Abstract

AimHealth service usage for eating disorders (EDs) has increased substantially; however, many tertiary hospitals lack resources for specialist ED services. Evidence-based guidelines outline ED management approaches for acute medical stabilisation in non-specialised services, including protocols for care across key disciplines (psychiatry, medicine and dietetics). The study aim was to evaluate collaboration of care within an Australian tertiary hospital following an eating disorder Inpatient Access and Treatment Pathway (IATP).MethodsThis retrospective cohort study reviewed 40 patients admitted with an ED diagnosis pre- (2019) and post- (2022) implementation of the IATP. The electronic medical record was utilised to gather patient demographics and health outcomes, and organisation of care (multidisciplinary team meetings, discharge planning).ResultsFollowing the implementation of the IATP, there was a 40% (p = .01) increase in appropriate discharge planning, classified as ED service referral or suitable community dietetic, medical and psychology follow-up. There was a significant increase in the Care Adherence Score (p = .004) which quantified organisation of care, utilising four key dichotomous variables. There was also a significant an increase in starting energy prescription (5900 KJ vs 4480 KJ, p = .046).ConclusionsA local IATP supported a significant increase in multidisciplinary collaboration and care adherence, appropriate discharge planning and starting energy provision.