Utilization Review and Resident Education

The reasons for psychiatric hospitalization are not always taught clearly and formally to psychiatric residents; screening criteria employed in utilization review can be a tool for helping residents gather data and make decisions about the admission or continued stay of patients. On the admitting and inpatient units of the Payne Whitney Psychiatric Clinic, residents use sets of criteria for admission and for continued stay, with accompanying guidelines and clinical examples, as part of their training. The authors outline principles used in developing the criteria, including the belief that they should be applicable independent of diagnosis. They suggest that in a teaching hospital screening criteria should be taken as standards, and that they should be developed as part of the educational program and only then introduced into utilization review.