# 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

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*This template is maintained by AtomicQMS. For questions, open an issue in this repository.*