APS Evaluation Overview

Chris Finn and Roy Perlis

1. Patient will arrive at triage, walk-in clinic or ED consult. Check to see if APS has received a referral on patient.

2. Decisions at triage: [see triage]

- APS or medicine?

- Level of containment/restraint needed

- Likely admission? If so, get things rolling early (see #5)

3. Inform RN and remainder of team of new patient.

4. Begin evaluation

5. Required for hospitalization (not necessarily in this order):

a. labs (order as soon as possible!)

b. physical exam [see medical clearance]

c. psychiatric assessment/note

d. face sheet from registration (insurance/contact info)

e. hospital bed located

- via FAST: fax EDDS note and face sheet to

855-3831, call 855-3141 to let them know

- on your own: record the name of the accepting MD

- on Blake 11: call unit, enter admit orders, sign 12a

f. insurance approval: [see insurance]

- record authorization #, reviewer name, # days

g. travel paperwork:

- Cobra, 12a (pink paper), Medicare/Medicaid transfer

h. ambulance (ask someone to call)

6. Required for discharge:

a. EDDS note

b. contact existing treaters to make them aware of APS visit.

c. arrange follow-up:

- with current treater

- with community clinic, N. Suffolk Mental Health,

Partners outpatient clinics

- APS can provide short-term psychopharm follow-up

d. discharge note signed by patient