Clinical Updates in Emergency Psychiatry: Integrated Care at its Best, sponsored by ACLP's Emergency Psychiatry SIG and the American Association for Emergency Psychiatry and The Behavioral Emergency Section, ACEP

Abstract: Behavioral emergencies make up an increasing volume of Emergency Department (ED) visits. CL Psychiatrists are often called to provide emergent care for this highly complex population. The CL physician coordinates acute psychiatric needs with ED providers, liaisons with outpatient providers and provides leadership for ultimate disposition, all while assessing and treating the crisis that brought the patient to the hospital. The outcome is never predetermined. Using current literature, case based interactive format and panel discussions, this course will provide critical updates on some of the most pressing topics that clinicians will face.

Liaison with your ED doc; What we want to know

Dr. MacKenzie, an Emergency Medicine doctor, will explore crucial strategies for effective collaboration. We will discuss essential strategies, tips, and tricks that can be employed to ensure that consults are comprehensive, efficient, and tailored for EM. We’ll learn the bridge between what EM doctors want to know and what they need to know. Attendees will leave with actionable insights to enhance their consultative practice and improve patient outcomes.

Updates in Emergency Suicide Assessment

Dr. Simpson discusses an approach to risk assessment in the ED. Attendees will learn and apply standardized approaches to complex suicide risk assessment. Regulatory and legal requirements impacting the standard of care and clinical decision-making in this setting are presented for effective disposition planning. The importance of concurrent violence risk assessment is introduced alongside similarities and differences to suicide risk management. Attendees can improve their own practice and adapt these strategies for teaching trainees and teams.

Culturally Informed Psychiatric Assessments in the ED

Dr. Khosla will discuss and demonstrate culturally informed psychiatric assessments in ED settings to facilitate optimal wellbeing of patients. Evidence-base to support the value of culturally responsive assessment in improving patient experience and decreasing behavioral agitation will be discussed. Case based examples will demonstrate formulating and testing both culture-specific and alternative hypotheses (impairment/dysfunction) through shifting cultural lenses done in a time-efficient manner conducive to emergency settings.

ED Boarding: Turning Time into Care

Dr. Stiebel, boarded in CL and EM reviews the history our current boarding crisis. This cohort typically receives minimal active care. We will review current trends facilitating disposition including tele-medicine and crisis units. We will discuss how to implement a mental health care plan allowing for proactive nursing interventions, health promoting programming and medical interventions. Attendees will learn how to transform a period of benign neglect into a meaningful recovery plan.

Emerging Trends in “Medical Clearance”

Dr Amin reviews the complexities of evaluating psychiatric patients in the ED. This cohort has significant comorbidities with limited outpatient medical access. These patients may not offer their medical histories, and may not know their medicines. The question remains, what exactly makes a patient “medically clear”, and this will vary between clinical situations, specialties and ultimate disposition. We will discuss current best practices for this collaborative care setting; determining what labs, if any, should be ordered and when a patient is ready for transfer to inpatient mental health.