Telepsychiatry Consultation for Medical and Surgical Inpatient Units

Graziane, Julie; Gopalan, Priya; Cahalane, Jack

doi:10.1016/j.psym.2017.08.008

Cited by 25 publications

(6 citation statements)

References 13 publications

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“…Perhaps, one of the most significant developments for all PCLPSs has been the rapid adoption of teleconsultation. While some studies have reported on teleconsultation use by adult CL services prior to the pandemic 44 , 45 , 46 , similar experience in PCLPS settings has not been reported. Despite all institutions reporting early challenges with technology availability, changes to documentation requirements, billing practices and logistical issues related to service delivery, the PCLPS transition to teleconsultation has generally been successful.…”

Section: Discussionmentioning

confidence: 95%

Adaptations Made to Pediatric Consultation-Liaison Psychiatry Service Delivery During the Early Months of the COVID-19 Pandemic: A North American Multisite Survey

Brahmbhatt

Mournet

Malas

et al. 2021

Journal of the Academy of Consultation-Liaison Psychiatry

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Background The COVID-19 pandemic led to rapid changes in clinical service delivery across hospital systems nationally. Local realities and resources were key driving factors impacting workflow changes, including for pediatric consultation-liaison psychiatry service (PCLPS) providers. Objective This study aims to describe the early changes implemented by 22 PCLPSs from the US and Canada during the COVID-19 pandemic. Understanding similarities and differences in adaptations made to PCLPS care delivery can inform best practices and future models of care. Methods A 20-point survey relating to PCLPS changes during the COVID-19 pandemic was sent to professional listservs. Baseline hospital demographics, hospital and PCLPS workflow changes, and PCLPS experience were collected from March 20, 2020 – April 28, 2020 and August 18, 2020 – September 10, 2020. Qualitative data were collected from responding sites. An exploratory thematic analysis approach was used to analyze the qualitative data that was not dependent on pre-determined coding themes. Descriptive statistics were calculated using Microsoft Excel. Results 22 academic hospitals in the US and Canada responded to the survey, with an average of 303 beds/hospital. Most respondents (18/22) were children’s hospitals. Despite differences in regional impact of COVID-19 and resource availability, there was significant overlap in respondent experiences. Restricted visitation to one caregiver, use of virtual rounding, ongoing trainee involvement, and an overall low number of COVID-positive pediatric patients were common. While there was variability in PCLPS care delivery occurring virtually versus in person, all respondents maintained some level of on-site presence. Technological limitations and pediatric provider preference led to increased on-site presence. Conclusions To our knowledge, this is the first multi-center study exploring pandemic-related PCLPS changes in North America. Findings of this study demonstrate that PCLPSs rapidly adapted to COVID-19 realities. Common themes emerged that may serve as a model for future practice. However, important gaps in understanding their effectiveness and acceptability need to be addressed. This multi-site survey highlights the importance of establishing consensus through national professional organizations to inform provider and hospital practices.

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Section: Discussionmentioning

confidence: 95%

Adaptations Made to Pediatric Consultation-Liaison Psychiatry Service Delivery During the Early Months of the COVID-19 Pandemic: A North American Multisite Survey

Brahmbhatt

Mournet

Malas

et al. 2021

Journal of the Academy of Consultation-Liaison Psychiatry

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“…Telepsychiatry has been most widely used in outpatient and ED settings but has also been used to conduct inpatient psychiatric consultations when access to in-person psychiatric providers is limited. 101,102 In the wake of the COVID-19 pandemic in 2020 and associated attempts to limit traffic in hospitals for infection-control purposes, many hospitals rapidly implemented pediatric telepsychiatry consultation models. As these programs roll out, there will be a need for future studies to evaluate the efficacy of telepsychiatry in the inpatient pediatric setting, as such programs may allow for expanded access to child psychiatric C-L services across the country.…”

Section: Technological Innovationmentioning

confidence: 99%

Pediatric Consultation-Liaison Psychiatry: An Update and Review

2020

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Background: In recent years, there has been an increasing burden of child and adolescent mental illness recognized in the United States, and the need for pediatric mental health care is growing. Pediatric consultation-liaison (C-L) psychiatrists are increasingly playing a role in the management of medical and psychiatric disease for pediatric patients. The field is a fast-moving one, with understanding of new neuropsychiatric disease entities; reformulation of prior disease entities; and new interdisciplinary treatments and models of care. Methods: In this study, we aim to review recent advances in the field of pediatric C-L psychiatry, including new diagnostic entities, updated management of frequently encountered clinical presentations, and developments in systems of care. Conclusion: The advances in pediatric C-L psychiatry are broad and serve to promote more streamlined, evidence-based care for the vulnerable population of psychiatrically ill pediatric medical patients. More work remains to determine the most effective interventions for the wide array of presentations seen by pediatric C-L psychiatrists.

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“…In a few of the studies, these models have been coupled with a “stepped-care approach.” The target populations are patients admitted in rural psychiatry hospitals, psychiatry units for special populations, consultation–liaison (CL) with medical or surgical units, and in an emergency area waiting for admission to inpatient care. 6 – 23 …”

Section: Models Of Telepsychiatry For Inpatient Carementioning

confidence: 99%

“…In another university setting providing TP to peripheral hospitals, a psychologist was available as part of the primary medical/surgical team at the periphery, who did the initial assessment. 9 …”

Section: Models Of Telepsychiatry For Inpatient Carementioning

confidence: 99%

A Review of Models and Efficacy of Telepsychiatry for Inpatient Service Delivery: Proposing a Model for Indian Settings

Ghosh

Verma

Lal

2020

Indian Journal of Psychological Medicine

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Background: The use of telepsychiatry (TP) for inpatient service delivery is still an emerging field and there is limited literature on its practice and evidence. This review was conducted with the objectives of (a) exploring the models of TP for inpatient service delivery, (b) qualitative synthesis of the efficacy of TP in inpatient settings, and (c) proposing a best-fit model of TP-based inpatient care for Indian settings. Methods: An electronic database search was conducted on July 22, 2020, in PubMed, Directory of Open Access Journals, and Google Scholar for relevant articles. Seventeen articles were included in the review. Results: The review revealed three models for TP-based inpatient care; direct care model, teleconsultation model, and the collaborative care model. Preliminary evidence suggests that TP is cost-effective and reliable, and that patients and service providers are highly satisfied with this approach. Evidence gaps were seen for some diagnostic categories such as psychosis and for extremes of age groups. Based on the existing models, we propose an Indian model for implementing TP in inpatient settings. Conclusion: Promising initial results and the evidence gaps highlight the need for further research in this area.

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Telepsychiatry Consultation for Medical and Surgical Inpatient Units

Cited by 25 publications

References 13 publications

Adaptations Made to Pediatric Consultation-Liaison Psychiatry Service Delivery During the Early Months of the COVID-19 Pandemic: A North American Multisite Survey

Adaptations Made to Pediatric Consultation-Liaison Psychiatry Service Delivery During the Early Months of the COVID-19 Pandemic: A North American Multisite Survey

Pediatric Consultation-Liaison Psychiatry: An Update and Review

A Review of Models and Efficacy of Telepsychiatry for Inpatient Service Delivery: Proposing a Model for Indian Settings

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