Consultation-liaison outcome evaluation system (CLOES): Resident or private attending physicians' concordance with consultants' recommendations

Systematic investigation of consultee concordance with the recommendations of the psychiatric consultant in general medical settings can enhance the role of the consultant as well as measure the efficacy of the psychiatric consultation service. Two hundred psychiatric consultations in a community based teaching hospital were studied for concordance with suggestions for psychotropic medications and diagnostic tests as well as the representation of the psychiatric diagnosis in the discharge summary. Results indicated that orders for medications and suggestions for diagnostic tests had a greater yield if the consultant personally wrote such orders. There was no difference in concordance rates between consultees who were private practitioners or resident physicians. Finally psychiatric diagnoses of dysthymic disorders and adjustment disorders were more likely to be omitted from the discharge summary than other psychiatric disorders.