Some patients may need a psychiatric hospitalization. However, hospitalizing a patient in a psychiatric unit needs to follow certain procedures. First, the psychiatric wards cannot provide the same level of medical care as other hospital units therefore the patient has to first be medically cleared (which means that the patient could be discharged home, if not for an active psychiatric condition).
Once the patient is medically cleared and the suspicion is that the patient poses imminent danger either to self or to others, or is gravely disabled due to mental illness, the PET team needs to be called to determine if the patient meets the criteria for psychiatric hospitalization. Psychiatrists cannot put any patient on hold so there is no point in delaying calling for the PET team until the patient is seen by a psychiatrist. If you think the patient is in need of psychiatric hospitalization, get the medical clearance from the attending physician and call PET at (855) 245-2443. A social worker’s involvement at any point in this process is highly recommended, if not required.
Please note that even if the psychiatrist recommends that the patient needs to be psychiatrically hospitalized, and the patient is medically cleared, the PET team clinician may decide against psychiatric hospitalization. They may conclude that the patient doesn’t meet the criteria to be put on hold. This may happen because the PET team clinician doesn’t have access to EPIC and may not be aware of all the behaviors documented there, so please print this information for them (focus on the documentation indicating behaviors showing imminent danger to self or others and grave disability). Even if such documentation is provided and the PET team clinician still doesn’t find the patient “holdable,” please ask them for the courtesy phone to call the psychiatrist or other physician who recommended psychiatric hospitalization and PET evaluation.
In summary, if the patient may need psychiatric hospitalization do the following:
- Obtain medical clearance and document it.
- Call PET team at (855) 245-2443.
- Print EPIC notes that document patient behaviors indicating imminent danger to self or others (verbal threats of physical harm or suicide, raising fists or other violent gesturing, kicking, spitting, biting, cutting, hitting, clear plan and/or intent for suicide, pushing staff, throwing objects, etc).
- Call attending for transfer orders, if PET recommends psychiatric hospitalization.
- If the patient is not put on hold and not transferred to a psychiatric facility, have PET team clinician call the psychiatrist who recommended calling for PET.