* Site 'C' comprises 2 PESs located in separate general hospitals. The same staff covered both sites.
1 The yearly observation period at site 'A' began in June whereas it began in January at sites 'B' and 'C'.
2 The closure of a neighboring PES, an increase in PES observation beds from 8 to 16, the opening of an outpatient day hospital.
3 The closing of a PES approximately 10 km away.
4 The gradual downsizing of a local psychiatric facility, a 30% reduction in acute general hospital psychiatric beds, the addition of specialized social workers in the PES both for the day and evening shifts.