Background Consultation-liaison psychiatry (CLP) provides mental health expertise in general hospitals, where psychiatric comorbidities affect approximately 30% of patients. Following implementation of a new electronic referral system at Waikato Hospital, this study aimed to analyse referral quality and service utilisation patterns. Methods A 12-month retrospective audit was conducted from July 2023 to June 2024, analysing all CLP referrals using a new system incorporating the Identify and Rate the Aim of the Contact (IRAC) tool and referral quality metrics. Referral quality was assessed both pre- and post-patient evaluation using a five-point Likert scale. Results Of 939 referrals (789 unique patients), 63.7% were rated as relevant to highly relevant. The average referral quality score was 2.698 pre-assessment and 2.682 post-assessment. General Medicine generated the most referrals, while Obstetrics/Gynaecology and Neurology showed lower quality scores. The mean time from admission to re
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