Tip Sheet Psychiatric Emergency Services at RIH/HCH Patients requiring emergent psychiatric services at RIH/HCH are evaluated by a Psychiatric Emergency Service Team. Workflow for patients requiring psychiatric services at RIH/HCH; ; Patient is evaluated by EDRN or EDMD and determines a need for PES EDMD places an order for Adult or PEDI PES, Psychiatric Emergency Services. o This order drives the patientt to now appear on the PES System list. Once the patient is discharges from the ED, the pt will be removed from from the PES system list o *You should still receive a phone call with the consult request. The EPIC order does not replace a verbal request. The PES providers complete a Master Initial Evaluation (and for attendings, a Medicare note or progress note, or cosign a resident s note) and document Authorization into Epic if required Discharge from the ED includes the completion of discharge instructions and creation of an AVS, After Visit Summary Transfers to facilities outside of Lifespan will require printing the pertinent clinical information and faxing by hand until further notice. Admission to a Lifespan facility will require insurance authorization and documentation of authorization, and placement of inpatient orders. Try It Out 1. EDMD or RN places Order for PES (adult or child)- user can search PES 2. PES Providers use the PES System List to view patients requiring psych emergency services
3. The evaluating clinician opens the patient s emergency encounter by double clicking on their name in the PES list. (GATEWAY CLINICIANS SHOULD ASSIGN THEMSELVES) The clinician reviews/updates/completes the patient history, identifies problems, home medications, and completes an Intial Evaluation (search Master IE for smart text) 4. Attendings can complete a medicare note (search BH Medicare) or a progress note (search Beh Health Progress Note) depending on the level of service, or cosign a resident s note. 5. History Section: This section is the patient level information that will be easily viewable at all levels of care.. Medical and Surgical History Family History: (note: comments written here are viewable by the patient in their patient portal) Alcohol/Drug/Smoking/Sexual History (note- only the smoking history is viewable in the patient portal)
Additional Documentation options for History can be added by selecting the History button. Final Social History will appear as below:
6. From the Notes Activity, use the Master IE to document the Initial Evaluation Authorization- Lifepsan behavioral health clinicians will be documenting Authoriztion into Lifeschart. There is an interface into AllScripts for ongoing management of claims. To Document Authorization for admission to the same hospital: The PES Provider obtains the Authorizaiton from payer and documents in Epic. This can be done right from the Patient List page. You can use the Auth/Cert Information link. * This is only for patient begin admitted to the same facility
To document Authorization for Admission to another Lifespan Hospital. If patient is to be admitted at a different facility, the clinician can open the future pending account and document the Authorization in the future account 8 The future Admission must be created by Patient Registration to complete this step >open Chart review and locate the Pending Future Admission >highlight the future encounter, and select the >Encounter button Once the future encounter opens, open the >Social Work navigator and open the >Behavioral Health Navigator Once the Authorization screens open you can document
Disharge If a patient is to be discharged home the provider can: a. Document specific discharge instructions b. Refer to an outside provider c. Prescribe medications d. Provide letters
e. Make an Appointment f. Follow Up Providers g. Generate an AVS, After Visit Summary 2014 Epic Systems Corporation. Confidential.