Sync template from atomicqms-style deployment

.gitea/workflows/atomicai.yml

@@ -0,0 +1,77 @@
+name: AtomicAI Mental Health Inpatient Assistant
+
+on:
+  issue_comment:
+    types: [created]
+  issues:
+    types: [opened, assigned]
+  pull_request:
+    types: [opened, synchronize, assigned]
+  pull_request_review_comment:
+    types: [created]
+
+jobs:
+  claude-assistant:
+    runs-on: ubuntu-latest
+    if: |
+      github.actor != 'atomicqms-service' &&
+      (
+      (github.event_name == 'issue_comment' && contains(github.event.comment.body, '@atomicai')) ||
+      (github.event_name == 'issues' && github.event.action == 'opened' && contains(github.event.issue.body, '@atomicai')) ||
+      (github.event_name == 'pull_request' && github.event.action == 'opened' && contains(github.event.pull_request.body, '@atomicai')) ||
+      (github.event_name == 'pull_request_review_comment' && contains(github.event.comment.body, '@atomicai')) ||
+      (github.event.action == 'assigned' && github.event.assignee.login == 'atomicai')
+      )
+
+    permissions:
+      contents: write
+      issues: write
+      pull-requests: write
+
+    steps:
+      - uses: actions/checkout@v4
+        with:
+          fetch-depth: 0
+
+      - name: Run AtomicAI Mental Health Inpatient Assistant
+        uses: https://beta.atomicqms.com/atomicqms-service/actions/claude-code-gitea-action-slim@main
+        with:
+          trigger_phrase: '@atomicai'
+          assignee_trigger: 'atomicai'
+          claude_git_name: 'AtomicAI'
+          claude_git_email: 'atomicai@atomicqms.local'
+          custom_instructions: |
+            You are AtomicAI, an AI assistant specialized in Mental Health Inpatient Quality Management.
+
+            ## Your Expertise
+            - Psychiatric hospital accreditation (Joint Commission, CMS)
+            - Involuntary commitment and patient rights
+            - Seclusion and restraint policies and documentation
+            - Acute psychiatric stabilization protocols
+            - Suicide precautions and observation levels
+            - Medication administration in psychiatric settings
+            - Milieu therapy and unit safety
+            - Discharge planning and aftercare coordination
+            - Behavioral emergency response (Code Green)
+            - 42 CFR Part 2 and HIPAA compliance
+
+            ## Document Creation Guidelines
+            - Place Clinical SOPs in SOPs/Clinical/
+            - Place Safety SOPs in SOPs/Safety/
+            - Place Emergency Protocols in Protocols/Emergency/
+            - Place Nursing SOPs in SOPs/Nursing/
+            - Place Patient Rights in Policies/Patient-Rights/
+            - Place Assessment Forms in Forms/Assessment/
+
+            ## Numbering Convention
+            - SOP-PSY-XXX for Psychiatric SOPs
+            - SOP-SAF-XXX for Safety SOPs
+            - SOP-NUR-XXX for Nursing SOPs
+            - PRO-EMR-XXX for Emergency Protocols
+            - POL-XXX for Policies
+            - FRM-XXX for Forms
+
+            Always create branches and submit changes as Pull Requests for review.
+            Prioritize patient safety, dignity, and least restrictive interventions.
+          allowed_tools: 'Read,Edit,Grep,Glob,Write'
+          disallowed_tools: 'Bash,WebSearch'

Forms/Assessment-Tools/FRM-MHI-002-Safety-Assessment.md

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+# Inpatient Safety Assessment
+
+| Form ID | FRM-MHI-002 | Revision | 1.0 |
+|---------|-------------|----------|-----|
+
+---
+
+## Patient Information
+
+| Field | Entry |
+|-------|-------|
+| Patient Name | |
+| MRN | |
+| Date of Birth | |
+| Unit/Room | |
+| Admission Date | |
+| Date of Assessment | |
+| Time of Assessment | |
+| Assessor Name | |
+| Assessor Credentials | |
+
+---
+
+## Suicide Risk Assessment
+
+### Current Suicidal Ideation
+
+| Question | Response |
+|----------|----------|
+| Are you having thoughts of suicide or self-harm? | ☐ Yes ☐ No |
+| If yes, how often? | ☐ Fleeting ☐ Intermittent ☐ Persistent |
+| How strong is the urge to act on these thoughts? | ☐ None ☐ Mild ☐ Moderate ☐ Strong ☐ Overwhelming |
+| Do you have a plan? | ☐ Yes ☐ No |
+| If yes, describe plan: | |
+| Do you have access to means? | ☐ Yes ☐ No |
+| Do you intend to act on these thoughts? | ☐ Yes ☐ No ☐ Ambivalent |
+
+### Suicidal Behaviors
+
+| Behavior | Present |
+|----------|---------|
+| Recent suicide attempt (within 30 days) | ☐ Yes ☐ No |
+| If yes, date and method: | |
+| Interrupted or aborted attempt | ☐ Yes ☐ No |
+| Preparatory behaviors (writing note, giving away possessions, etc.) | ☐ Yes ☐ No |
+
+### Historical Risk Factors
+
+| Factor | Present |
+|--------|---------|
+| Previous suicide attempt(s) | ☐ Yes ☐ No |
+| If yes, number and methods: | |
+| Self-harm without suicidal intent | ☐ Yes ☐ No |
+| Family history of suicide | ☐ Yes ☐ No |
+| Previous psychiatric hospitalization | ☐ Yes ☐ No |
+
+### Clinical Risk Factors
+
+| Factor | Present |
+|--------|---------|
+| Depression | ☐ Yes ☐ No |
+| Hopelessness | ☐ Yes ☐ No |
+| Anxiety/agitation | ☐ Yes ☐ No |
+| Psychosis | ☐ Yes ☐ No |
+| Command hallucinations (self-harm) | ☐ Yes ☐ No |
+| Intoxication/withdrawal | ☐ Yes ☐ No |
+| Chronic pain/medical illness | ☐ Yes ☐ No |
+| Recent discharge from psychiatric hospital | ☐ Yes ☐ No |
+| Insomnia | ☐ Yes ☐ No |
+
+### Precipitating Factors
+
+| Factor | Present |
+|--------|---------|
+| Recent loss (relationship, job, housing) | ☐ Yes ☐ No |
+| Recent humiliation/shame | ☐ Yes ☐ No |
+| Legal problems | ☐ Yes ☐ No |
+| Financial problems | ☐ Yes ☐ No |
+| Anniversary of loss | ☐ Yes ☐ No |
+| Other: | ☐ Yes ☐ No |
+
+### Protective Factors
+
+| Factor | Present |
+|--------|---------|
+| Reasons for living | ☐ Yes ☐ No |
+| Future orientation | ☐ Yes ☐ No |
+| Social support | ☐ Yes ☐ No |
+| Religious/spiritual beliefs against suicide | ☐ Yes ☐ No |
+| Responsibility for children/pets | ☐ Yes ☐ No |
+| Fear of death/pain | ☐ Yes ☐ No |
+| Engaged in treatment | ☐ Yes ☐ No |
+| Therapeutic alliance | ☐ Yes ☐ No |
+
+### Suicide Risk Level
+
+☐ **Low Risk** - No current ideation, few risk factors, strong protective factors
+☐ **Moderate Risk** - Ideation without plan/intent, some risk factors, some protective factors
+☐ **High Risk** - Ideation with plan, intent, access to means; multiple risk factors; few protective factors
+☐ **Imminent Risk** - Immediate danger, requires 1:1 observation
+
+---
+
+## Violence/Homicide Risk Assessment
+
+### Current Homicidal/Violent Ideation
+
+| Question | Response |
+|----------|----------|
+| Are you having thoughts of hurting someone else? | ☐ Yes ☐ No |
+| Is there a specific person? | ☐ Yes ☐ No |
+| If yes, identify: | |
+| Do you have a plan to harm this person? | ☐ Yes ☐ No |
+| Do you have access to weapons? | ☐ Yes ☐ No |
+| Do you intend to act on these thoughts? | ☐ Yes ☐ No |
+
+### Historical Risk Factors
+
+| Factor | Present |
+|--------|---------|
+| History of violence | ☐ Yes ☐ No |
+| History of weapons use | ☐ Yes ☐ No |
+| Criminal history | ☐ Yes ☐ No |
+| History of impulsive behavior | ☐ Yes ☐ No |
+| Childhood conduct disorder | ☐ Yes ☐ No |
+| Victim of abuse/violence | ☐ Yes ☐ No |
+
+### Clinical Risk Factors
+
+| Factor | Present |
+|--------|---------|
+| Command hallucinations (violence) | ☐ Yes ☐ No |
+| Paranoid delusions | ☐ Yes ☐ No |
+| Manic symptoms | ☐ Yes ☐ No |
+| Active substance use | ☐ Yes ☐ No |
+| Medication non-adherence | ☐ Yes ☐ No |
+| Lack of insight | ☐ Yes ☐ No |
+
+### Situational Factors
+
+| Factor | Present |
+|--------|---------|
+| Active interpersonal conflict | ☐ Yes ☐ No |
+| Perceived threats | ☐ Yes ☐ No |
+| Access to potential victims | ☐ Yes ☐ No |
+| History with identified target | ☐ Yes ☐ No |
+
+### Violence Risk Level
+
+☐ **Low Risk** - No ideation, few risk factors
+☐ **Moderate Risk** - General ideation, some risk factors
+☐ **High Risk** - Specific ideation, identified target, plan, multiple risk factors
+
+### Duty to Warn/Protect
+
+| Field | Entry |
+|-------|-------|
+| Is there an identifiable potential victim? | ☐ Yes ☐ No |
+| Has duty to warn been triggered? | ☐ Yes ☐ No |
+| If yes, actions taken: | |
+| Notification date/time: | |
+| Law enforcement notified? | ☐ Yes ☐ No |
+| Potential victim notified? | ☐ Yes ☐ No |
+
+---
+
+## Self-Harm Risk Assessment
+
+| Question | Response |
+|----------|----------|
+| Are you having urges to hurt yourself (without suicidal intent)? | ☐ Yes ☐ No |
+| Method typically used: | |
+| When did you last engage in self-harm? | |
+| What triggers self-harm urges? | |
+| How do you typically cope with these urges? | |
+
+---
+
+## Elopement/AWOL Risk
+
+| Factor | Present |
+|--------|---------|
+| Expressed desire to leave AMA | ☐ Yes ☐ No |
+| Involuntary admission status | ☐ Yes ☐ No |
+| History of elopement | ☐ Yes ☐ No |
+| Agitation or restlessness | ☐ Yes ☐ No |
+| External pressures to leave | ☐ Yes ☐ No |
+| Poor insight into need for treatment | ☐ Yes ☐ No |
+
+### Elopement Risk Level
+
+☐ Low ☐ Moderate ☐ High
+
+---
+
+## Fall Risk Assessment
+
+| Factor | Points | Present |
+|--------|--------|---------|
+| Age 65+ | 2 | ☐ |
+| History of falls | 3 | ☐ |
+| Impaired gait/balance | 2 | ☐ |
+| Psychotropic medications | 2 | ☐ |
+| Sedation | 2 | ☐ |
+| Confusion/disorientation | 2 | ☐ |
+| Sensory impairment | 1 | ☐ |
+| Toileting frequency | 1 | ☐ |
+| **Total Score** | | |
+
+**Risk Level:** ☐ Low (0-4) ☐ Moderate (5-9) ☐ High (10+)
+
+---
+
+## Assigned Precautions
+
+### Observation Level
+
+☐ 1:1 Continuous (within arm's reach)
+☐ 1:1 Visual (constant visual)
+☐ Close observation (q5-15 min)
+☐ Routine observation (q15-30 min)
+☐ Open
+
+### Additional Precautions
+
+| Precaution | Ordered |
+|------------|---------|
+| Suicide precautions | ☐ |
+| Self-harm precautions | ☐ |
+| Violence precautions | ☐ |
+| Elopement precautions | ☐ |
+| Fall precautions | ☐ |
+| Seizure precautions | ☐ |
+| Aspiration precautions | ☐ |
+| Assault precautions | ☐ |
+
+### Environmental Modifications
+
+☐ Safety room (ligature-resistant)
+☐ Remove sharps from access
+☐ Remove potential ligature materials
+☐ Supervised shaving
+☐ Supervised meals (plastic utensils)
+☐ Other: _____________
+
+---
+
+## Plan
+
+**Immediate Safety Interventions:**
+
+**Recommended Observation Level:**
+
+**Rationale for Level:**
+
+**Reassessment Schedule:**
+☐ Every shift
+☐ Daily
+☐ Other: _____________
+
+---
+
+## Physician Review
+
+| Field | Entry |
+|-------|-------|
+| Physician Name | |
+| Date/Time Reviewed | |
+| Agrees with Assessment | ☐ Yes ☐ No |
+| Orders Modified? | ☐ Yes ☐ No |
+| Modifications: | |
+| Signature | |
+
+---
+
+## Reassessment Log
+
+| Date/Time | Assessor | Risk Level Change | New Observation Level | Signature |
+|-----------|----------|-------------------|----------------------|-----------|
+| | | ☐ Yes ☐ No | | |
+| | | ☐ Yes ☐ No | | |
+| | | ☐ Yes ☐ No | | |
+| | | ☐ Yes ☐ No | | |
+
+---
+
+*Form FRM-MHI-002 Rev 1.0 - Inpatient Safety Assessment*

Forms/FRM-001-Document-Change-Request.md

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+# Document Change Request Form
+
+| Form ID | FRM-001 | Revision | 1.0 |
+|---------|---------|----------|-----|
+
+---
+
+## Section 1: Request Information
+
+| Field | Entry |
+|-------|-------|
+| Request Date | |
+| Requested By | |
+| Department | |
+
+## Section 2: Document Information
+
+| Field | Entry |
+|-------|-------|
+| Document Number | |
+| Document Title | |
+| Current Revision | |
+
+## Section 3: Change Description
+
+### Type of Change
+- [ ] New Document
+- [ ] Revision to Existing Document
+- [ ] Document Obsolescence
+
+### Description of Change
+*(Describe the proposed change in detail)*
+
+
+
+
+### Reason for Change
+*(Explain why this change is needed)*
+
+
+
+
+## Section 4: Impact Assessment
+
+### Affected Areas
+- [ ] Training Required
+- [ ] Other Documents Affected
+- [ ] Process Changes Required
+- [ ] Validation Impact
+
+### List Affected Documents
+
+
+## Section 5: Approvals
+
+| Role | Name | Signature | Date |
+|------|------|-----------|------|
+| Requester | | | |
+| Document Owner | | | |
+| Quality Assurance | | | |
+
+---
+
+*Form FRM-001 Rev 1.0*

Forms/FRM-003-CAPA-Form.md

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+# Corrective and Preventive Action (CAPA) Form
+
+| Form ID | FRM-003 | Revision | 1.0 |
+|---------|---------|----------|-----|
+
+---
+
+## Section 1: CAPA Identification
+
+| Field | Entry |
+|-------|-------|
+| CAPA Number | |
+| Date Initiated | |
+| Initiated By | |
+| CAPA Owner | |
+| Target Closure Date | |
+
+## Section 2: Classification
+
+### Type
+- [ ] Corrective Action
+- [ ] Preventive Action
+
+### Source
+- [ ] Customer Complaint
+- [ ] Internal Audit
+- [ ] External Audit
+- [ ] Process Deviation
+- [ ] Nonconforming Product
+- [ ] Management Review
+- [ ] Other: ____________
+
+### Priority
+- [ ] Critical (5 business days)
+- [ ] Major (15 business days)
+- [ ] Minor (30 business days)
+
+## Section 3: Problem Description
+
+*(Describe the nonconformity or potential nonconformity)*
+
+
+
+
+## Section 4: Immediate Containment
+
+*(Actions taken to contain the immediate impact)*
+
+
+
+
+## Section 5: Root Cause Investigation
+
+### Investigation Method Used
+- [ ] 5 Whys
+- [ ] Fishbone Diagram
+- [ ] Fault Tree Analysis
+- [ ] Other: ____________
+
+### Root Cause Determination
+
+
+
+
+## Section 6: Corrective/Preventive Actions
+
+| Action | Responsible | Due Date | Status |
+|--------|-------------|----------|--------|
+| | | | |
+| | | | |
+| | | | |
+
+## Section 7: Effectiveness Verification
+
+| Criteria | Method | Result |
+|----------|--------|--------|
+| | | |
+
+Verification Date: ____________
+Verified By: ____________
+
+## Section 8: Closure
+
+| Role | Name | Signature | Date |
+|------|------|-----------|------|
+| CAPA Owner | | | |
+| Quality Approval | | | |
+
+---
+
+*Form FRM-003 Rev 1.0*

Forms/FRM-006-Audit-Checklist.md

@@ -0,0 +1,56 @@
+# Internal Audit Checklist
+
+| Form ID | FRM-006 | Revision | 1.0 |
+|---------|---------|----------|-----|
+
+---
+
+## Audit Information
+
+| Field | Entry |
+|-------|-------|
+| Audit Number | |
+| Audit Date | |
+| Area/Process Audited | |
+| Lead Auditor | |
+| Auditee(s) | |
+
+---
+
+## Checklist Items
+
+| # | Requirement/Question | Reference | C/NC/NA | Evidence/Notes |
+|---|---------------------|-----------|---------|----------------|
+| 1 | Are current versions of applicable procedures available? | SOP-001 | | |
+| 2 | Are personnel trained on applicable procedures? | SOP-003 | | |
+| 3 | Are training records current and complete? | SOP-003 | | |
+| 4 | Are records properly maintained and retrievable? | SOP-001 | | |
+| 5 | Are nonconformities being documented and addressed? | SOP-002 | | |
+| 6 | Are CAPAs being completed on time? | SOP-002 | | |
+| 7 | Is equipment calibrated and maintained? | | | |
+| 8 | Are process controls being followed? | | | |
+| 9 | Are quality objectives being monitored? | | | |
+| 10 | | | | |
+
+**Legend:** C = Conforming, NC = Nonconforming, NA = Not Applicable
+
+---
+
+## Findings Summary
+
+| Finding # | Type | Description | Clause Reference |
+|-----------|------|-------------|------------------|
+| | | | |
+| | | | |
+
+---
+
+## Auditor Signature
+
+| Auditor | Signature | Date |
+|---------|-----------|------|
+| | | |
+
+---
+
+*Form FRM-006 Rev 1.0*

Forms/Training/FRM-004-Training-Record.md

@@ -0,0 +1,72 @@
+# Training Record Form
+
+| Form ID | FRM-004 | Revision | 1.0 |
+|---------|---------|----------|-----|
+
+---
+
+## Section 1: Employee Information
+
+| Field | Entry |
+|-------|-------|
+| Employee Name | |
+| Employee ID | |
+| Department | |
+| Job Title | |
+
+## Section 2: Training Information
+
+| Field | Entry |
+|-------|-------|
+| Training Title | |
+| Training Date | |
+| Training Duration | |
+| Trainer Name | |
+| Trainer Qualification | |
+
+### Training Type
+- [ ] Initial Training
+- [ ] Retraining
+- [ ] Refresher
+- [ ] Procedure Update
+
+### Delivery Method
+- [ ] Classroom
+- [ ] On-the-Job
+- [ ] Self-Study
+- [ ] Computer-Based
+- [ ] Other: ____________
+
+## Section 3: Training Content
+
+*(List topics covered or attach training materials)*
+
+
+
+
+## Section 4: Assessment
+
+### Assessment Method
+- [ ] Written Test
+- [ ] Practical Demonstration
+- [ ] Verbal Assessment
+- [ ] Observation
+
+### Assessment Results
+
+| Metric | Result |
+|--------|--------|
+| Score (if applicable) | |
+| Pass/Fail | |
+
+## Section 5: Signatures
+
+| Role | Name | Signature | Date |
+|------|------|-----------|------|
+| Trainee | | | |
+| Trainer | | | |
+| Supervisor | | | |
+
+---
+
+*Form FRM-004 Rev 1.0*

Policies/POL-001-Quality-Policy.md

@@ -0,0 +1,57 @@
+# Quality Policy
+
+| Document ID | POL-001 |
+|-------------|---------|
+| Title | Quality Policy |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+
+---
+
+## 1. Policy Statement
+
+[ORGANIZATION NAME] is committed to providing products and services that consistently meet customer requirements and applicable regulatory requirements. We strive for continual improvement of our Quality Management System to enhance customer satisfaction.
+
+## 2. Quality Objectives
+
+Our organization commits to:
+
+1. **Customer Focus**: Understanding and meeting customer needs and expectations
+2. **Regulatory Compliance**: Maintaining compliance with all applicable regulations and standards
+3. **Continuous Improvement**: Continually improving the effectiveness of our QMS
+4. **Employee Engagement**: Ensuring all employees understand their role in quality
+5. **Risk-Based Thinking**: Identifying and addressing risks and opportunities
+
+## 3. Management Commitment
+
+Top management demonstrates commitment to the QMS by:
+
+- Ensuring the quality policy is appropriate to the organization's purpose
+- Ensuring quality objectives are established and compatible with strategic direction
+- Ensuring integration of QMS requirements into business processes
+- Promoting the use of the process approach and risk-based thinking
+- Ensuring resources needed for the QMS are available
+- Communicating the importance of effective quality management
+- Ensuring the QMS achieves its intended results
+- Engaging, directing, and supporting persons to contribute to QMS effectiveness
+
+## 4. Scope
+
+This policy applies to all employees, contractors, and processes within the scope of our Quality Management System.
+
+## 5. Communication
+
+This policy shall be:
+- Communicated and understood within the organization
+- Available to relevant interested parties as appropriate
+- Reviewed for continuing suitability
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

README.md

@@ -1,3 +1,133 @@
-# mental-health-inpatient
+# Mental Health Inpatient Services Quality Management System
 
 A comprehensive QMS template designed for psychiatric hospitals, inpatient behavioral health units, and acute psychiatric care facilities.
+
+## 🏥 Designed For
+
+- **Psychiatric Hospitals** - Freestanding behavioral health facilities
+- **Hospital Psychiatric Units** - Inpatient psych units within general hospitals
+- **Crisis Stabilization Units** - Short-term acute psychiatric care
+- **Child/Adolescent Psychiatric Units** - Pediatric behavioral health
+- **Geriatric Psychiatric Units** - Older adult mental health care
+- **Forensic Psychiatric Facilities** - Court-ordered treatment settings
+- **Residential Treatment Centers** - Extended care facilities
+
+## 📋 Regulatory Framework
+
+This template supports compliance with:
+
+- **The Joint Commission** - Behavioral Health Care accreditation
+- **CMS Conditions of Participation** - Psychiatric hospital requirements
+- **State Mental Health Authority** - State licensing regulations
+- **42 CFR Part 482** - Hospital Conditions of Participation
+- **HIPAA** - Patient privacy requirements
+- **EMTALA** - Emergency psychiatric presentations
+- **State Commitment Laws** - Involuntary treatment regulations
+- **APA Practice Guidelines** - Psychiatric treatment standards
+- **NPSG** - National Patient Safety Goals (behavioral health)
+- **Nurse Practice Act** - Psychiatric nursing regulations
+
+## Repository Structure
+
+```
+├── SOPs/
+│   ├── Admission-Discharge/   # Voluntary/involuntary admission, discharge planning
+│   ├── Assessment/            # Psychiatric evaluation, risk assessment, treatment planning
+│   ├── Safety/                # Suicide prevention, elopement, environmental safety
+│   ├── Restraint-Seclusion/   # Use, monitoring, debriefing, documentation
+│   ├── Medication/            # Psychotropic meds, PRN protocols, monitoring
+│   └── General/               # Document control, training, CAPA
+├── Forms/
+│   ├── Admission-Forms/       # Consent, legal status, voluntary/involuntary
+│   ├── Assessment-Tools/      # PHQ-9, GAD-7, Columbia, mental status
+│   ├── Safety-Plans/          # Suicide safety plans, precaution levels
+│   ├── Restraint-Records/     # Restraint/seclusion orders, monitoring logs
+│   ├── Treatment-Plans/       # Individualized treatment plans, goals
+│   └── Training/              # Competency assessments
+├── Policies/                  # Institutional policies
+├── Work-Instructions/         # Step-by-step procedures
+└── Templates/                 # Document templates
+```
+
+## Document Numbering Convention
+
+- **POL-XXX**: Policies
+- **SOP-ADM-XXX**: Admission/Discharge SOPs
+- **SOP-ASM-XXX**: Assessment SOPs
+- **SOP-SAF-XXX**: Safety SOPs
+- **SOP-RS-XXX**: Restraint/Seclusion SOPs
+- **SOP-MED-XXX**: Medication SOPs
+- **WI-XXX**: Work Instructions
+- **FRM-XXX**: Forms and Records
+
+## 🤖 AI-Powered Assistance
+
+This repository includes **AtomicAI**, your mental health QMS assistant. Mention `@atomicai` in any issue or pull request to:
+
+- Draft admission and assessment procedures
+- Create suicide risk assessment protocols
+- Generate restraint/seclusion procedures
+- Develop medication management SOPs
+- Create safety and elopement prevention plans
+- Review documents for Joint Commission compliance
+
+### Example Prompts
+
+- "@atomicai create an SOP for suicide risk assessment using Columbia-Suicide Severity Rating Scale"
+- "@atomicai draft an involuntary admission procedure per state requirements"
+- "@atomicai write a restraint/seclusion policy meeting CMS requirements"
+- "@atomicai create a psychiatric medication monitoring protocol"
+- "@atomicai develop an elopement prevention and response procedure"
+- "@atomicai create a therapeutic milieu safety checklist"
+
+## Getting Started
+
+1. **Align with State Laws** - Review involuntary commitment and patient rights laws
+2. **Establish Safety Protocols** - Implement suicide prevention and environmental safety
+3. **Define Assessment Standards** - Standardize psychiatric evaluation tools
+4. **Set Up Medication Monitoring** - Configure psychotropic medication protocols
+5. **Train Staff** - Crisis intervention and de-escalation training
+
+## Key Documents to Create First
+
+1. **Suicide Risk Assessment SOP** - Standardized screening and intervention
+2. **Involuntary Admission Procedure** - Legal holds and commitment process
+3. **Restraint and Seclusion Policy** - CMS-compliant R/S procedures
+4. **Environmental Safety Checklist** - Ligature risk and contraband
+5. **Elopement Prevention SOP** - Risk assessment and precautions
+6. **Treatment Planning SOP** - Individualized treatment plan development
+7. **Discharge Planning Procedure** - Safe transitions and aftercare
+
+## Special Considerations for Psychiatric Inpatient Care
+
+### Patient Safety
+- Suicide risk screening and assessment
+- Environmental safety (ligature points, sharps)
+- Contraband prevention and searches
+- Elopement risk and prevention
+- Patient supervision levels
+
+### Legal and Rights
+- Voluntary vs. involuntary status
+- Informed consent for treatment
+- Patient rights notification
+- Grievance procedures
+- Advance directives and healthcare proxies
+
+### Restraint and Seclusion
+- Least restrictive interventions
+- Physician orders and time limits
+- Continuous monitoring requirements
+- Debriefing and documentation
+- Reduction initiatives
+
+### Treatment
+- Psychiatric evaluation and diagnosis
+- Treatment plan development
+- Medication management and monitoring
+- Group and individual therapy
+- Discharge planning and aftercare
+
+---
+
+*This template is maintained by AtomicQMS. For questions, open an issue in this repository.*

SOPs/General/SOP-001-Document-Control.md

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+# Standard Operating Procedure: Document Control
+
+| Document ID | SOP-001 |
+|-------------|---------|
+| Title | Document Control |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | Quality Assurance |
+
+---
+
+## 1. Purpose
+
+To establish a procedure for the creation, review, approval, distribution, and control of documents within the Quality Management System.
+
+## 2. Scope
+
+This procedure applies to all controlled documents including:
+- Policies
+- Standard Operating Procedures (SOPs)
+- Work Instructions
+- Forms and Templates
+- Specifications
+- External documents of external origin
+
+## 3. Responsibilities
+
+### 3.1 Document Owner
+- Responsible for document content and accuracy
+- Initiates document creation and revision
+- Ensures periodic review is performed
+
+### 3.2 Quality Assurance
+- Maintains the document control system
+- Assigns document numbers
+- Manages document distribution
+- Archives obsolete documents
+
+### 3.3 Approvers
+- Review and approve documents before release
+- Ensure documents are adequate for intended purpose
+
+## 4. Procedure
+
+### 4.1 Document Creation
+
+1. Identify the need for a new document
+2. Request document number from Quality Assurance
+3. Draft document using appropriate template
+4. Include all required header information
+5. Submit for review and approval
+
+### 4.2 Document Review and Approval
+
+1. Route document to appropriate reviewers
+2. Reviewers provide comments within 5 business days
+3. Author addresses all comments
+4. Final approval by designated approver
+5. Quality Assurance releases document
+
+### 4.3 Document Numbering
+
+Documents shall be numbered according to the following convention:
+
+| Type | Prefix | Example |
+|------|--------|---------|
+| Policy | POL | POL-001 |
+| SOP | SOP | SOP-001 |
+| Work Instruction | WI | WI-001 |
+| Form | FRM | FRM-001 |
+
+### 4.4 Revision Control
+
+1. All changes require documented justification
+2. Changes follow same review/approval process as new documents
+3. Revision number increments with each approved change
+4. Revision history maintained in document footer
+
+### 4.5 Document Distribution
+
+1. Current versions available in document control system
+2. Obsolete versions marked and archived
+3. Training on new/revised documents as needed
+
+### 4.6 Periodic Review
+
+1. Documents reviewed at least every 2 years
+2. Review documented even if no changes made
+3. Reviews may result in revision or reaffirmation
+
+## 5. Related Documents
+
+- FRM-001 Document Change Request Form
+- FRM-002 Document Review Record
+
+## 6. Definitions
+
+| Term | Definition |
+|------|------------|
+| Controlled Document | Document managed under document control system |
+| Obsolete | Document no longer valid for use |
+| Revision | Updated version of a document |
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

SOPs/General/SOP-002-CAPA.md

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+# Standard Operating Procedure: Corrective and Preventive Action (CAPA)
+
+| Document ID | SOP-002 |
+|-------------|---------|
+| Title | Corrective and Preventive Action |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | Quality Assurance |
+
+---
+
+## 1. Purpose
+
+To establish a systematic process for identifying, investigating, correcting, and preventing nonconformities and potential nonconformities.
+
+## 2. Scope
+
+This procedure applies to:
+- Product and process nonconformities
+- Customer complaints
+- Audit findings
+- Process deviations
+- Potential nonconformities identified through risk analysis
+
+## 3. Definitions
+
+| Term | Definition |
+|------|------------|
+| Corrective Action | Action to eliminate the cause of a detected nonconformity |
+| Preventive Action | Action to eliminate the cause of a potential nonconformity |
+| Root Cause | Fundamental reason for a nonconformity |
+| Effectiveness Check | Verification that implemented actions achieved desired results |
+
+## 4. Responsibilities
+
+### 4.1 CAPA Owner
+- Investigates the issue
+- Identifies root cause
+- Develops and implements corrective/preventive actions
+- Verifies effectiveness
+
+### 4.2 Quality Assurance
+- Manages CAPA system
+- Assigns CAPA numbers
+- Tracks CAPA status
+- Reviews and approves CAPAs
+- Reports CAPA metrics to management
+
+### 4.3 Management
+- Provides resources for CAPA implementation
+- Reviews CAPA trends
+- Ensures timely closure
+
+## 5. Procedure
+
+### 5.1 CAPA Initiation
+
+1. Identify nonconformity or potential nonconformity
+2. Document issue on CAPA Form (FRM-003)
+3. Classify severity and priority
+4. Assign CAPA owner
+
+### 5.2 Investigation
+
+1. Gather relevant data and evidence
+2. Interview personnel involved
+3. Review related documents and records
+4. Use appropriate investigation tools:
+   - 5 Whys
+   - Fishbone Diagram
+   - Failure Mode Analysis
+
+### 5.3 Root Cause Analysis
+
+1. Identify potential root causes
+2. Verify root cause through evidence
+3. Document root cause determination
+4. Consider systemic implications
+
+### 5.4 Action Development
+
+1. Develop corrective/preventive actions
+2. Assign responsibilities and due dates
+3. Assess actions for:
+   - Appropriateness to problem severity
+   - Impact on other processes
+   - Resource requirements
+
+### 5.5 Implementation
+
+1. Execute approved actions
+2. Document implementation evidence
+3. Update affected documents/processes
+4. Provide training as needed
+
+### 5.6 Effectiveness Verification
+
+1. Define effectiveness criteria
+2. Allow sufficient time for actions to take effect
+3. Collect and analyze data
+4. Document verification results
+5. If ineffective, reopen CAPA for further action
+
+### 5.7 Closure
+
+1. Review all CAPA documentation
+2. Verify all actions completed
+3. Confirm effectiveness verified
+4. Obtain approval for closure
+
+## 6. CAPA Metrics
+
+Quality Assurance shall track and report:
+- Number of open CAPAs
+- CAPA aging
+- On-time closure rate
+- Effectiveness rate
+- CAPAs by category/source
+
+## 7. Related Documents
+
+- FRM-003 CAPA Form
+- SOP-003 Nonconforming Product Control
+- SOP-004 Customer Complaints
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

SOPs/General/SOP-003-Training.md

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+# Standard Operating Procedure: Training and Competence
+
+| Document ID | SOP-003 |
+|-------------|---------|
+| Title | Training and Competence |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | Human Resources / Quality |
+
+---
+
+## 1. Purpose
+
+To ensure personnel performing work affecting product quality are competent based on appropriate education, training, skills, and experience.
+
+## 2. Scope
+
+This procedure applies to:
+- All employees performing quality-affecting activities
+- Contractors and temporary personnel
+- Personnel requiring GxP training
+
+## 3. Responsibilities
+
+### 3.1 Supervisors/Managers
+- Identify training needs for their personnel
+- Ensure training is completed before performing tasks
+- Evaluate competence of personnel
+- Maintain department training records
+
+### 3.2 Human Resources
+- Coordinate training programs
+- Maintain central training database
+- Track training compliance
+- Archive training records
+
+### 3.3 Quality Assurance
+- Develop QMS-related training
+- Approve training curricula for GxP activities
+- Audit training compliance
+
+### 3.4 Employees
+- Complete assigned training on time
+- Maintain current qualifications
+- Report training needs to supervisor
+
+## 4. Procedure
+
+### 4.1 Training Needs Assessment
+
+1. Identify competence requirements for each role
+2. Document requirements in job descriptions
+3. Assess current competence of personnel
+4. Identify training gaps
+
+### 4.2 Training Curriculum Development
+
+1. Define learning objectives
+2. Develop training materials
+3. Identify delivery method:
+   - Classroom
+   - On-the-job
+   - Self-study
+   - Computer-based
+4. Define assessment criteria
+5. Obtain approval from Quality (for GxP training)
+
+### 4.3 Training Delivery
+
+1. Schedule training session
+2. Document attendance
+3. Deliver training per curriculum
+4. Assess comprehension through:
+   - Written test (minimum 80% passing)
+   - Practical demonstration
+   - Supervisor observation
+
+### 4.4 Training Documentation
+
+Training records shall include:
+- Employee name and ID
+- Training title and date
+- Trainer name and qualifications
+- Assessment results
+- Signatures
+
+### 4.5 Retraining Requirements
+
+Retraining is required when:
+- Significant document revisions occur
+- Performance deficiencies identified
+- Extended absence from job function
+- Periodic requalification due
+
+### 4.6 New Employee Orientation
+
+All new employees shall complete:
+1. Company orientation
+2. Quality system overview
+3. Job-specific training
+4. SOP read and understand for applicable procedures
+
+## 5. Training Records Retention
+
+- Training records maintained for duration of employment
+- Records retained 3 years after employee departure
+- Records available for regulatory inspection
+
+## 6. Related Documents
+
+- FRM-004 Training Record Form
+- FRM-005 Training Assessment Form
+- Job Descriptions
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

SOPs/General/SOP-004-Internal-Audit.md

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+# Standard Operating Procedure: Internal Audit
+
+| Document ID | SOP-004 |
+|-------------|---------|
+| Title | Internal Audit |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | Quality Assurance |
+
+---
+
+## 1. Purpose
+
+To establish a systematic approach for conducting internal audits to verify the effectiveness of the Quality Management System.
+
+## 2. Scope
+
+This procedure covers:
+- QMS process audits
+- Compliance audits
+- Product audits
+- System audits
+
+## 3. Definitions
+
+| Term | Definition |
+|------|------------|
+| Audit | Systematic, independent examination to determine conformance |
+| Auditor | Person qualified to perform audits |
+| Finding | Observation of conformance or nonconformance |
+| Observation | Noted item not rising to level of finding |
+
+## 4. Responsibilities
+
+### 4.1 Lead Auditor
+- Plans and schedules audits
+- Prepares audit checklists
+- Conducts audit activities
+- Reports audit findings
+
+### 4.2 Quality Manager
+- Maintains audit program
+- Qualifies auditors
+- Reviews audit reports
+- Reports to management
+
+### 4.3 Auditee
+- Provides access to areas/records
+- Responds to findings
+- Implements corrective actions
+
+## 5. Procedure
+
+### 5.1 Annual Audit Schedule
+
+1. Develop annual audit schedule considering:
+   - Previous audit results
+   - Process criticality
+   - Regulatory requirements
+   - Changes to processes
+2. Ensure all QMS processes audited at least annually
+3. Obtain management approval
+4. Communicate schedule to affected areas
+
+### 5.2 Auditor Qualification
+
+Auditors shall:
+- Complete auditor training course
+- Conduct at least 2 audits under supervision
+- Be independent of area being audited
+- Maintain competence through ongoing audits
+
+### 5.3 Audit Preparation
+
+1. Review applicable procedures and standards
+2. Review previous audit reports
+3. Prepare audit checklist
+4. Notify auditee of audit scope and schedule
+5. Confirm auditor availability
+
+### 5.4 Conducting the Audit
+
+1. Hold opening meeting with auditee
+2. Execute audit checklist
+3. Gather objective evidence:
+   - Document review
+   - Personnel interviews
+   - Process observation
+4. Document findings with evidence
+5. Classify findings:
+   - Major Nonconformance
+   - Minor Nonconformance
+   - Observation
+6. Hold closing meeting
+
+### 5.5 Audit Reporting
+
+1. Complete audit report within 5 business days
+2. Report shall include:
+   - Audit scope and criteria
+   - Personnel interviewed
+   - Findings with evidence
+   - Recommendations
+3. Distribute report to auditee and management
+
+### 5.6 Finding Resolution
+
+1. Auditee responds with corrective action plan within 10 business days
+2. Quality reviews and approves plan
+3. Auditee implements corrective actions
+4. Auditor verifies effectiveness
+5. Close finding upon verification
+
+## 6. Audit Records
+
+Maintain for 5 years:
+- Audit schedules
+- Checklists
+- Reports
+- Corrective action records
+
+## 7. Related Documents
+
+- FRM-006 Audit Checklist Template
+- FRM-007 Audit Report Template
+- SOP-002 CAPA
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

SOPs/General/SOP-005-Management-Review.md

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+# Standard Operating Procedure: Management Review
+
+| Document ID | SOP-005 |
+|-------------|---------|
+| Title | Management Review |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | Quality Assurance |
+
+---
+
+## 1. Purpose
+
+To ensure top management reviews the Quality Management System at planned intervals to ensure its continuing suitability, adequacy, and effectiveness.
+
+## 2. Scope
+
+This procedure applies to the periodic management review of the QMS, including all processes and quality objectives.
+
+## 3. Frequency
+
+Management reviews shall be conducted:
+- At least annually
+- More frequently if significant changes occur
+- As needed based on quality performance
+
+## 4. Responsibilities
+
+### 4.1 Quality Manager
+- Prepares management review agenda and materials
+- Facilitates the meeting
+- Documents meeting minutes and action items
+- Tracks completion of action items
+
+### 4.2 Top Management
+- Attends management review meetings
+- Reviews QMS performance data
+- Makes decisions on QMS improvements
+- Allocates resources as needed
+
+### 4.3 Department Managers
+- Provides input data for their areas
+- Attends management review
+- Implements assigned action items
+
+## 5. Management Review Inputs
+
+The following shall be considered:
+
+### 5.1 Actions from Previous Reviews
+- Status of action items
+- Effectiveness of implemented actions
+
+### 5.2 Changes in Context
+- Internal changes (organization, resources)
+- External changes (regulations, market)
+
+### 5.3 QMS Performance
+- Customer satisfaction and feedback
+- Quality objectives achievement
+- Process performance metrics
+- Nonconformities and corrective actions
+- Audit results
+- Supplier performance
+
+### 5.4 Resource Adequacy
+- Personnel
+- Infrastructure
+- Work environment
+
+### 5.5 Risk and Opportunities
+- Risk assessment results
+- Effectiveness of risk controls
+- New opportunities identified
+
+### 5.6 Improvement Opportunities
+- Process improvements
+- Product improvements
+- QMS enhancements
+
+## 6. Management Review Outputs
+
+Decisions and actions related to:
+- Improvement of QMS and processes
+- Product improvement
+- Resource needs
+- Changes to quality policy or objectives
+
+## 7. Documentation
+
+### 7.1 Meeting Minutes
+- Date and attendees
+- Items discussed
+- Decisions made
+- Action items with owners and due dates
+
+### 7.2 Record Retention
+- Management review records retained for 5 years
+- Available for regulatory inspection
+
+## 8. Related Documents
+
+- FRM-008 Management Review Agenda Template
+- FRM-009 Management Review Minutes Template
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

SOPs/Patient-Care/SOP-MHI-001-Admission-Assessment.md

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+# Standard Operating Procedure: Psychiatric Inpatient Admission and Assessment
+
+| Document ID | SOP-MHI-001 |
+|-------------|-------------|
+| Title | Psychiatric Inpatient Admission and Comprehensive Assessment |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | Inpatient Psychiatry |
+
+---
+
+## 1. Purpose
+
+To establish standardized procedures for the admission and comprehensive psychiatric assessment of patients to the inpatient psychiatric unit, ensuring safety, regulatory compliance, and appropriate treatment planning.
+
+## 2. Scope
+
+This procedure applies to all psychiatric inpatient admissions including:
+- Voluntary admissions
+- Involuntary/emergency detentions
+- Transfers from other facilities
+- Forensic admissions
+- Medical clearance requirements
+
+## 3. Responsibilities
+
+### 3.1 Admitting Psychiatrist
+- Conduct psychiatric evaluation
+- Determine admission criteria met
+- Establish initial treatment plan
+- Complete admission documentation
+
+### 3.2 Nursing Staff
+- Conduct nursing admission assessment
+- Complete safety assessment and precautions
+- Inventory personal belongings
+- Orient patient to unit
+
+### 3.3 Social Worker
+- Conduct psychosocial assessment
+- Contact family/supports
+- Begin discharge planning
+- Assess resource needs
+
+### 3.4 Mental Health Technicians
+- Assist with admission process
+- Implement observation levels
+- Secure patient belongings
+
+## 4. Definitions
+
+| Term | Definition |
+|------|------------|
+| Voluntary Admission | Patient consents to hospitalization |
+| Involuntary Hold | Legal detention for evaluation/treatment without consent |
+| 1:1 Observation | Continuous direct observation by staff member |
+| Elopement Precautions | Measures to prevent unauthorized departure |
+| Medical Clearance | Confirmation patient is medically stable for psychiatric unit |
+
+## 5. Procedure
+
+### 5.1 Pre-Admission Requirements
+
+#### 5.1.1 Medical Clearance
+
+Before admission to psychiatric unit, patient must have:
+- [ ] Medical history and physical examination
+- [ ] Vital signs within acceptable parameters
+- [ ] Laboratory studies per protocol
+- [ ] Medical conditions stabilized or treatment plan in place
+- [ ] Clearance from ED physician or medicine consultant
+
+**Minimum Laboratory Studies:**
+| Test | Required |
+|------|----------|
+| Complete Blood Count | ☐ |
+| Comprehensive Metabolic Panel | ☐ |
+| Urinalysis | ☐ |
+| Urine Drug Screen | ☐ |
+| Blood Alcohol Level | ☐ |
+| Pregnancy Test (if applicable) | ☐ |
+| Additional (as indicated) | |
+
+#### 5.1.2 Legal Status Determination
+
+| Status | Documentation Required |
+|--------|------------------------|
+| Voluntary | Signed voluntary admission form |
+| Involuntary | Completed legal detention documents, physician certification |
+| Court-Ordered | Court order, sheriff documentation |
+| Minor | Parent/guardian consent OR court order |
+
+### 5.2 Admission Process
+
+#### 5.2.1 Patient Arrival
+1. Greet patient and escort to admission area
+2. Verify identity with two identifiers
+3. Confirm legal status and documentation
+4. Apply identification band
+
+#### 5.2.2 Safety Search and Contraband Removal
+
+**Required for all admissions:**
+- [ ] Wand metal detector screening
+- [ ] Personal search (same-gender staff)
+- [ ] Belongings search
+- [ ] Remove and secure contraband
+
+**Contraband List:**
+| Always Remove | Document Securely |
+|--------------|-------------------|
+| Sharps, blades | Medications |
+| Ligature materials (belts, cords, laces) | Valuables |
+| Drugs/alcohol | Electronics (per policy) |
+| Weapons | Lighters/matches |
+| Glass items | |
+
+Document all items on FRM-MHI-001 Belongings Inventory.
+
+#### 5.2.3 Observation Level Assignment
+
+| Level | Criteria | Monitoring |
+|-------|----------|------------|
+| 1:1 Continuous | Active suicidal/homicidal, severe agitation | Within arm's reach |
+| Close Observation | Recent attempt, high risk | Every 5-15 minutes |
+| Routine | Low/moderate risk | Every 15-30 minutes |
+| Open | No safety concerns | Per unit routine |
+
+### 5.3 Psychiatric Evaluation
+
+#### 5.3.1 Comprehensive Psychiatric Assessment
+
+**Required within 24 hours of admission:**
+
+1. **Chief Complaint and History of Present Illness**
+   - Current symptoms and duration
+   - Precipitating events
+   - Previous episodes
+   - Current stressors
+
+2. **Psychiatric History**
+   - Previous diagnoses
+   - Hospitalizations
+   - Outpatient treatment
+   - Medication trials
+   - ECT or other treatments
+
+3. **Suicide/Violence Risk Assessment**
+
+   **Suicide Risk:**
+   | Factor | Present |
+   |--------|---------|
+   | Current ideation | ☐ Yes ☐ No |
+   | Plan | ☐ Yes ☐ No |
+   | Intent | ☐ Yes ☐ No |
+   | Access to means | ☐ Yes ☐ No |
+   | Previous attempts | ☐ Yes ☐ No |
+   | Protective factors | |
+
+   **Violence Risk:**
+   | Factor | Present |
+   |--------|---------|
+   | Homicidal ideation | ☐ Yes ☐ No |
+   | Identified target | ☐ Yes ☐ No |
+   | History of violence | ☐ Yes ☐ No |
+   | Command hallucinations | ☐ Yes ☐ No |
+   | Access to weapons | ☐ Yes ☐ No |
+
+4. **Substance Use History**
+   - Substances used
+   - Quantity, frequency, route
+   - Last use
+   - Withdrawal history
+   - Treatment history
+
+5. **Medical History**
+   - Chronic conditions
+   - Current medications
+   - Allergies
+   - Recent medical issues
+
+6. **Family History**
+   - Psychiatric disorders
+   - Substance use disorders
+   - Suicide history
+
+7. **Social/Developmental History**
+   - Education
+   - Employment
+   - Living situation
+   - Relationships
+   - Legal history
+   - Trauma history
+
+8. **Mental Status Examination**
+   | Domain | Findings |
+   |--------|----------|
+   | Appearance | |
+   | Behavior | |
+   | Speech | |
+   | Mood | |
+   | Affect | |
+   | Thought Process | |
+   | Thought Content | |
+   | Perceptions | |
+   | Cognition | |
+   | Insight | |
+   | Judgment | |
+
+9. **Diagnosis (DSM-5)**
+   - Primary diagnosis
+   - Secondary diagnoses
+   - Medical conditions
+   - Psychosocial stressors
+
+### 5.4 Nursing Admission Assessment
+
+Complete within **8 hours** of admission:
+
+- [ ] Vital signs
+- [ ] Pain assessment
+- [ ] Fall risk assessment
+- [ ] Skin assessment
+- [ ] Nutritional screen
+- [ ] Medication reconciliation
+- [ ] Allergies verified
+- [ ] Current symptoms
+- [ ] Functional status
+- [ ] Sleep patterns
+- [ ] Safety precautions implemented
+
+### 5.5 Treatment Planning
+
+#### 5.5.1 Initial Treatment Plan (within 24 hours)
+- Provisional diagnoses
+- Initial medication orders
+- Observation level
+- Activity level
+- Diet
+- Laboratory/diagnostic orders
+- Consultation requests
+- Initial goals
+
+#### 5.5.2 Comprehensive Treatment Plan (within 72 hours)
+- Multidisciplinary input
+- Patient participation
+- Measurable goals
+- Interventions by discipline
+- Discharge criteria
+- Estimated length of stay
+
+### 5.6 Patient Rights and Orientation
+
+#### 5.6.1 Rights Information
+Provide and document receipt of:
+- [ ] Patient rights document
+- [ ] Grievance procedure
+- [ ] Privacy practices
+- [ ] Voluntary/involuntary rights specific to status
+- [ ] Right to refuse treatment (voluntary)
+- [ ] Advance directive information
+
+#### 5.6.2 Unit Orientation
+- [ ] Room assignment
+- [ ] Unit layout (exits, bathroom, common areas)
+- [ ] Schedule (meals, groups, visiting)
+- [ ] Rules and expectations
+- [ ] How to contact staff
+- [ ] Telephone use
+- [ ] Personal belongings policy
+
+### 5.7 Special Populations
+
+#### 5.7.1 Minors
+- Parental/guardian involvement
+- Age-appropriate assessments
+- Educational needs assessment
+- Child protective services notification if indicated
+
+#### 5.7.2 Geriatric Patients
+- Enhanced medical monitoring
+- Cognitive assessment
+- Fall precautions
+- Medication review for appropriateness
+
+#### 5.7.3 Forensic Patients
+- Legal hold documentation
+- Notification requirements
+- Security considerations
+- Court date tracking
+
+## 6. Documentation
+
+- FRM-MHI-001 Belongings Inventory
+- FRM-MHI-002 Admission Safety Assessment
+- FRM-MHI-003 Suicide Risk Assessment
+- Psychiatric Evaluation
+- Nursing Admission Assessment
+- Social Work Assessment
+- Treatment Plan
+- Patient Rights Acknowledgment
+
+## 7. Regulatory Compliance
+
+| Regulation | Requirement |
+|------------|-------------|
+| The Joint Commission | Assessment within 24 hours |
+| CMS | Treatment plan within 72 hours |
+| State Mental Health Code | Involuntary hold procedures |
+| EMTALA | Medical screening examination |
+
+## 8. References
+
+- State mental health statutes
+- The Joint Commission standards
+- CMS Conditions of Participation
+- Institutional policies
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

SOPs/Safety/.gitkeep

@@ -0,0 +1 @@
+# Placeholder

Templates/SOP-Template.md

@@ -0,0 +1,62 @@
+# Standard Operating Procedure: [Title]
+
+| Document ID | SOP-XXX |
+|-------------|---------|
+| Title | [Title] |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | [DEPARTMENT] |
+
+---
+
+## 1. Purpose
+
+[State the purpose of this procedure]
+
+## 2. Scope
+
+[Define the scope and applicability]
+
+## 3. Responsibilities
+
+### 3.1 [Role 1]
+- [Responsibility]
+- [Responsibility]
+
+### 3.2 [Role 2]
+- [Responsibility]
+- [Responsibility]
+
+## 4. Definitions
+
+| Term | Definition |
+|------|------------|
+| | |
+
+## 5. Procedure
+
+### 5.1 [Section Title]
+
+[Procedure steps]
+
+### 5.2 [Section Title]
+
+[Procedure steps]
+
+## 6. Related Documents
+
+- [List related procedures, forms, etc.]
+
+## 7. References
+
+- [External standards, regulations, etc.]
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

Work Instructions/WI-001-Template.md

@@ -0,0 +1,68 @@
+# Work Instruction: [Title]
+
+| Document ID | WI-001 |
+|-------------|--------|
+| Title | [Title] |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | [DEPARTMENT] |
+
+---
+
+## 1. Purpose
+
+[Describe the purpose of this work instruction]
+
+## 2. Scope
+
+[Define what activities this instruction covers]
+
+## 3. Safety Precautions
+
+- [List any safety requirements]
+- [Personal protective equipment needed]
+- [Hazards to be aware of]
+
+## 4. Equipment/Materials Required
+
+| Item | Specification |
+|------|---------------|
+| | |
+| | |
+
+## 5. Procedure
+
+### Step 1: [Title]
+[Detailed instructions]
+
+### Step 2: [Title]
+[Detailed instructions]
+
+### Step 3: [Title]
+[Detailed instructions]
+
+## 6. Acceptance Criteria
+
+[Define what constitutes successful completion]
+
+## 7. Records
+
+| Record | Location | Retention |
+|--------|----------|-----------|
+| | | |
+
+## 8. References
+
+- [Related SOPs]
+- [Specifications]
+- [Standards]
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |