CAP I Inpatient Unit Rotation (Lakeshore and Highland Park Hospital)

Patient Care

Residents will demonstrate the ability to comprehensively assess, discuss, document, and intervene in situations concerning patients' potential for self-harm or harm to others.

This will include:

  • Knowledge of admission procedures including involuntary admissions and admission orders
  • Crisis/ emergency management of acutely disturbed children and adolescents including assessment of risk based on known risk factors
  • Knowledge of inpatient treatment standards, procedures, and psychopharmacolgy and the differences from outpatient
  • Effective intervention to minimize risk inclding psychopharmacolgic and mechanical restraints
  • Implement prevention methods for self-harm and harm to others.

Medical Knowledge

Residents will demonstrate knowledge of treatment in acutely disturbed children and adolescents, and recognize the differences from an outpatient practice This includes evaluation and treatment of:

  • Patients with suicidal or homicidal ideation
  • Patients with psychotic disorders
  • Crisis interventions
  • Differential diagnosis in emergency situations, with special emphasis on neurologic and medical presentations mimicking psychiatric illness
  • Treatment methods in emergency situations
  • Patients with violent behaviors

Residents will also demonstrate knowledge of medical legal and risk management issues pertinent to the practice of inpaqtient child and adolescent psychiatry, including issues surrounding criteria for involuntary admission, right to consent for treatment and various confidentiality issues.

Interpersonal and Communication Skills

Residents will demonstrate:

  • The ability to work effectively within a multidisciplinary team structure as a member, consultant and leader
  • The ability to form relationships with patients and professionals in an acute care setting.
  • Knowledge of liaison techniques related to coordination of care with outpatient mental health professionals, community ased agencies, schools, residential treatment programs, and the Department of Children and Family Services.
  • The ability to exhibit professional, ethically sound behavior and attitude in all patient and professional interactions

Professionalism

Residents will be empathic, respectful, curious, open, nonjudgmental, collaborative, able to tolerate ambiguity and demonstrate confidence in the efficacy of supportive therapy.

Residents will be sensitive to the sociocultural, socioeconomic, educational issues that arise in the therapeutic relationship.

Practice-based Learning and Improvement

The resident will evaluate caseload and practice experience in a systematic manner. Daily rounds are held to review the patient's treatment and informal feedback is given. Residents will identify areas of strengths and weakness, and work with the attending to make a performance improvement plan.

Systems-based Practice

The resident will:

  1. Learn how to advocate for optimal patient care within the limits of the health care delivery system by understanding the resources available for increased outpatient services or residential care including community and school based resources.
  2. Learn how to consult with emergency doctors and other specialist including state agencies around inpatient admissions
  3. Learn how to be the leader in a psychiatric emergency, keeping the patient and staff safety as priority
  4. Review cases with supervisors and other staff in ER/ C-L Rounds, and when appropriate, in quality improvement rounds (M&M)
  5. Understand the different levels of care in acute inpatient, partial hospitalization, intensive outpatient, 23-hour crisis evaluation and management units and be able to define the typical symptomatology that can be best managed in each treatment environment.