title: Medical clearance in the psychiatric emergency setting: a call for more standardization.
abstract: Literature suggests little standardization in the practice of medical clearance of patients who present to emergency rooms in psychiatric crisis. The present quality improvement study examined current practice in a large psychiatric teaching hospital setting. Using chart review, the completeness of physical examination was examined for 10 body areas in a random sample of 20 psychiatric patients admitted via a psychiatric emergency department (ED) during a one-month period. Charts were examined for four professional groups - family physicians or nurse practitioners, psychiatry residents, medical students and general ED physicians. Results indicated a wide variation in documentation across the four groups and some body systems that were consistently never assessed. To improve standardization, a physical examination form is proposed that is user friendly and based on a review of current literature.
authors.affiliation: Department of Psychiatry, University of Toronto, Toronto, Ontario.
authors.forename: Tanya
authors.initials: T
authors.lastname: Pinto
authors.forename: Brittany
authors.initials: B
authors.lastname: Poynter
authors.forename: Janet
authors.initials: J
authors.lastname: Durbin
mesh_terms: D002170:Canada; D004637:Emergency Services, Psychiatric; D006778:Hospitals, Psychiatric; D006801:Humans; D008485:Medical Audit; D010808:Physical Examination / Q000592:standards*; D012189:Retrospective Studies