Behavioral Health in the ED

Many psychiatrists are currently facing a rapid conversion of services to a telehealth model during the COVID-19 pandemic, and so we’d like to share some of our industry experience to help make the transition as easy and seamless as possible. Here are 4 key tips for establishing a successful consult-liaison telepsychiatry service in your hospital.

Step 1: Communication

Think about how the process will best fit within your system. It can be helpful to identify staff leaders who are positioned to familiarize their team with the process changes. These leaders can help train other staff members, so it’s important to make sure these key staff members have a thorough understanding of the process so they can disseminate protocols to their team members at future meetings.

Adding the new process into your EMR system is also an important step so that on-site staff can order a virtual psychiatric consultation. Having physical copies of the new workflow available at easy-to-access points such as nursing stations and on equipment can also help staff with the transition.

Emailing the process changes to relevant stakeholders can help keep everyone in the loop as well.

Step 2: Collaboration with Staff

Hospital telepsychiatry programs require collaboration with in-person staff. Consider how you can support your staff during a difficult and anxiety-provoking transition.

Continue to be transparent, honest, and empathetic. Emphasize that the decision is based on national recommendations for patient-centered care. Telepsychiatry will help reduce patient contact and risk to help ensure the health of your hospital workforce.

Some health systems may find it easier to start with a hybrid model, where an “in-person” psychiatrist initially assists with the technology and staff education to help with the transition.

Step 3: Develop a Workflow

New process changes work best when there are limited disruptions to previous processes. When creating your workflow, consider how to best imitate your current consult workflow. Ensure that your telepsychiatry devices have a designated space in the hospital where they can be easily stored and located when needed. It is also helpful to plug in your devices as often as possible and make sure that they are always plugged in when returned to their designated storage space. Video conferencing can often reduce battery power after just one patient visit.

All staff members must know how to orient the device to properly face the patient and place it as close to the bedside as possible for optimal audio and video quality. If possible, keep your videoconferencing software running and open at all times to decrease wait times for patients.

A contingency plan should also be in place to support patients who become agitated, need an interpreter, or need emergency medication. It is also important to consider how to create privacy for telepsychiatry appointments when there is more than one patient in the room.

Make sure that the staff knows who to contact for technology support on the device if needed. It can be helpful to put the contact number for IT on the copies of the workflow. Contact information for the patient’s nurse is also important to have available.

If a follow-up evaluation is required, it may be best to schedule a specific time in advance that is convenient for your nursing and facility staff.

Step 4: Hospital Equipment

Devices with integrated HD cameras are ideal for video calls. Devices should be securely attached to mobile stands for easy transport, and cords should be long enough to reach outlets in the patient rooms.

For both patient and staff safety, all devices should be equipped with a screen protector that can be easily wiped down with a disinfectant solution between uses. If possible, it can be helpful to keep these cleaners with the device as well as within easy reach of the device’s storage location.

If the software allows, it can be helpful to disable the picture-in-picture feature for video conferencing, as it can be distracting and even unsettling for patients to see themselves on screen. When choosing a video conferencing software, it is best to pick one that offers a Business Associate Agreement for HIPAA compliance purposes.

The devices should be tested in multiple locations of the hospital to ensure they have internet connectivity. Some devices may require after-market additions to enhance Wi-Fi signal and quality.

To download our guide to setting up a telepsychiatry service in your hospital, click here.

To arrange a demo of our solution, contact us at: info@mindcaresolutions.com or call 844-291-4535.