Information Sheet for Weekend Psychiatric Consultations/Dispositions

INPATIENT vs OUTPATIENT 1) Routine referrals for psychiatric care that do not require the patient to be seen urgently do not need to be seen in PES over the weekend. There is an outpatient referral form for Psychiatry in the Ad Hoc documentation. This form should be completed by referring MD, should list PCP, and is sufficient to notify Access that the patient needs to be scheduled. 2) The outpatient referral form may also be used for referrals to PES. 3) Please include a consultation question for our psychiatric team. 4) Please obtain patient’s consent before referring to psychiatry. 5) When possible, please refer patient back to current outpatient psychiatric provider to avoid duplicate efforts.

INPATIENT

6) If a patient on a medical or surgical floor is deemed medically stable for discharge over the weekend and in need of an urgent psychiatric evaluation where there is NOT a concern for harm to self/others and ability to care for self, the team shall call the PES resident to discuss with them that they will be discharging a patient to the PES waiting room. 7) If a patient on a medical or surgical floor is deemed medically stable for discharge over the weekend and in need of a psychiatric evaluation where there IS a concern for harm to self/others and ability to care for self, the team shall call the PES resident to discuss with them the POSSIBILITY of the patient being discharged to the secure area of PES for evaluation. (Keeping in mind that PES is fielding patients from its waiting room, its secure area, ambulances, and the UNM ED as well.) 8) If there is not room in the secure area of PES for this AT-RISK patient to be accepted, or there are too many other acute needs going on in PES in general, the patient must be KEPT on the medical/surgical floor until there is the possibility to be accepted. This may not be until Monday. 9) If a patient on a medical or surgical floor is deemed medically stable for discharge over the weekend and in need of a psychiatric HOSPITALIZATION (e.g. as determined by weekday C/L service), the team shall call the PES resident to discuss with them the POSSIBILITY of the patient being discharged to the secure area of PES for admission to an available psychiatric bed at the MHC. (If there are no available beds at the MHC, the patient must wait until a bed is available, generally on Monday.) 10) If a patient on a medical or surgical floor is NOT medically stable for discharge but is in need of a psychiatric clarification or opinion that cannot wait until Monday when the C/L team is available, the team may contact the PES resident on-call for this clarification. 11) If the PES resident is not available/too busy/unable to meet the need for clarification or opinion, and the attending physician of the team feels that a psychiatric clarification or opinion is necessary, he/she may contact the on-call attending psychiatrist to assist. 12) If a medical or surgical team cannot ascertain whether a patient who is/is not medically stable is at psychiatric risk or not, they may contact the PES on-call resident, and if they are not available, the on-call attending psychiatrist.

Davin Quinn