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