Care management in mental health services in England and Northern Ireland: do integrated organizations promote integrated practice?
This study concurs with previous research showing that structurally integrated health and social services in NI are more conducive towards, although insufficient to secure, integrated working. As the nature, type of services and ways of working appear to be broadly similar in England and NI, this may imply that greater structural integration per se may not lead to better service outcomes.
Advanced communication from a poison center was associated with earlier administration of AC in the ED for this population. Nevertheless, the duration to charcoal administration was frequently suboptimal. Triage and prehospital practices should be reexamined to improve timeliness of AC when indicated and consider exclusion of administration if beyond an appropriate time frame. Advanced notification should be the paradigm for all poison centers, and early response protocols for poison center referrals should be used by EDs.