Emergency/Consultation Psychiatry Smart-Phrases

[GoRhody]

Hi everyone! 

I’m a PA who has just begun a position as a provider in the psychiatric emergency area of a local hospital as well as doing psych consultations for the med/surg floors. 

I’m wondering if anyone has any good dot phrases/smart phrases that would be useful for my area of work, including templates for HPI, ROS, PE/MSE, Assessment/Plan, discharge, or anything else that may be relevant. 

Any help would be much appreciated - thanks in advance! 

[rev ronin]

This for EPIC, or which EMR?

I like building my own templates and phrases, YMMV.

[GoRhody]

30 minutes ago, rev ronin said:

This for EPIC, or which EMR?

I like building my own templates and phrases, YMMV.

This will be for Meditech. 

[ohiovolffemtp]

I never built any .phrases for this in Epic, but my general template for mental health/psyche assessments when I did a lot of intake for mental health patients in a trauma center (we had an ED psyche unit and an IP one) was:

• Mood is ____ with ____ affect, with values of things like pleasant, calm, agitated, angry, anxious, labile, etc for mood and congruent, flat, etc for affect
• Thought process is ___ with values like linear, disjointed, shows flight of ideas, etc.
• Judgment and insight are ____ with values like good, fair, poor, impaired
• Visual and/or auditory hallucinations are ____ with values like reported, observed, absent
• Suicidal/homicidal _____ with values like ideation, thoughts (with/without plan), attempts

I also always documented prior mental health tx or lack there of, and whether OP or IP, and compliance.

[PACShrink]

In Athena, you can browse and copy other providers macros. Maybe look through and see if some are already there for providers that did the same type of consultation...

Our practice has required templates for med eval and follow-up. We are allowed to add whatever we prefer as long as the template structure is the same.