Skip to content
This search input has a predictive search function. When 3 letters or more are entered, a number of predictive results appear in a dropdown. Use arrow keys to navigate and use the enter key to go to the page highlighted.
    RENEW JOIN
    Dashboard

    Patient Safety and Emergency Management

    There are several unique considerations to patient safety and emergency management when practicing telepsychiatry:

    • General Safety Protocols: Identify for your practice setting and population what safety protocols will be needed and practical. Consider identifying means for conveying practice safety protocols and policies, including in materials provided to patients before becoming a part of the practice, as well as incorporating this information into discussions orienting patients to the practice protocols. (Telehealth and Patient Safety. | PSNet, 2022) Setting expectations for your patients and your practice can facilitate more accurate assessments and next steps for intervention if emergency services are warranted.
      • Suggestions include:
        • Maintaining updated contact information for each patient including residential address and emergency contact information.
        • Providing informed consent regarding the limitations of engaging in video visits. This includes parameters for appropriate settings for visits to occur. Consider making recommendations that patients be in a private and safe space without distractions. For example, do not allow patients to drive during video visits and avoid loud public spaces to ensure providers can optimally assess patients while ensuring privacy. (Boisvert, 2021)
        • Maintaining contingency plans for clinical emergencies – including contact information for local authorities in the event of a crisis. In addition, you can request the phone number for a family member, friend, or neighbor to contact in the event of an emergency.
        • Developing your own protocol and criteria for referring to or alerting emergency services in the case of an emergency such as EMS. Consider both local and national emergency services. (Creating an Emergency Plan for Telebehavioral Health, 2022)
        • Depending on what is available in the area, maintain a roster of local emergency services which can be used to supplement your own assessment and/or engage patients who are not stable for outpatient care such as mobile crisis. (Wesolowski, 2022)
        • Consulting your malpractice carrier to review safety protocols and obtain advising for documentation.
        • Maintaining contingency plans for technical failures, such as continuing the interrupted video sessions by phone if internet service becomes unstable.
    • When starting the visit: Optimize image and sound quality to allow for inspection of the patient. Recommend they turn off notifications to reduce distractions. Confirm where the patient is located including an exact address and contact information in the event of an emergency or lost internet connection. If no address is available, be as specific as possible in case emergency services need to locate the patient. If additional people are present with the patient, identify who they are and if the patient consents to them being present during the visit.
    • Throughout the interview: Be mindful to assess the patient’s level of agitation, the potential for harm to self or others, as well as any safety hazards that might be accessible by the patient during the session. If a patient appears intoxicated, consider rescheduling the appointment.
      • Image and sound quality should be adjusted during the session to allow for the inspection of the patient for verbal and visual cues of agitation or other possible factors related to patient safety.
      • Consider using home blood pressure and heart rate monitoring, smart pill containers or mHealth applications, and actigraphy devices to help inform whether emergency services are warranted. (Telehealth for the Treatment of Serious Mental Illness and Substance Use Disorders, 2021)
    • If safety concerns present during the visit, follow the safety protocols established above and if possible, stay connected to the patient until emergency services can intervene.

    References

    1. Boisvert, S. (2021, January 6). Telehealth's Newest Safety Risk: Distracted Patients. The Doctors Company. Retrieved December 10, 2023, from https://www.thedoctors.com/articles/telehealths-newest-safety-risk-distracted-patients/
    2. Creating an emergency plan for telebehavioral health. (2022, December 7). Telehealth.HHS.gov. Retrieved December 10, 2023, from https://telehealth.hhs.gov/providers/best-practice-guides/telehealth-for-behavioral-health/preparing-patients-for-telebehavioral-health/creating-a-telehealth-emergency-plan
    3. Telehealth and Patient Safety. | PSNet. (2022, December 14). Patient Safety Network. Retrieved December 10, 2023, from https://psnet.ahrq.gov/primer/telehealth-and-patient-safety
    4. Telehealth for the Treatment of Serious Mental Illness and Substance Use Disorders. (2021). SAMHSA Publications. Retrieved December 10, 2023, from https://store.samhsa.gov/sites/default/files/pep21-06-02-001.pdf
    5. Wesolowski, H. (2022, July 13). Mobile Crisis Teams: Providing an Alternative to Law Enforcement for Mental Health Crises. NAMI. Retrieved December 10, 2023, from https://www.nami.org/Blogs/NAMI-Blog/July-2022/Mobile-Crisis-Teams-Providing-an-Alternative-to-Law-Enforcement-for-Mental-Health-Crises

    Medical leadership for mind, brain and body.

    Join Today