Clinical trial NCT05771545: Telepsychiatry to Enable Expedited Disposition of Psychiatric Emergencies
Official title: Telepsychiatry to Enable Expedited Disposition of Psychiatric Emergencies
Study type: OBSERVATIONAL
Overall status: ACTIVE_NOT_RECRUITING
Conditions: Psychiatric Emergency
Keywords: telepsychiatry
implementation science
Lead sponsor: Hebrew University of Jerusalem
Sponsor class: OTHER
First posted: 2023-03-16
Enrollment: 800
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: All patients who are evaluated for involuntary psychiatric admission via the ED, who meet the above criteria.

Brief summary: The goal of this observational study is to examine the effect of using a video link for evaluation of patients in the psychiatric emergency room. Under current Israeli law, the attending physician must come in to physically examine the patient before they can be admitted involuntarily. Patients often de-compensate and even may become violent while waiting for the attending to arrive. Previous studies have shown that evaluation of such patients via video-link has an extremely high concordance with in person evaluation. This study will compare patients who are evaluated via video-link with historical controls evaluated under usual conditions. This is an observational study, which is taking advantage of a change in practice to collect data on two different ways of delivering care, via chart reviews. If successful, this study will show that the video-link is feasible and acceptable to patients and staff. The following hypotheses will be tested:

1. The intervention will result in shorter ED time compared to historical controls.
2. The intervention will result in fewer violent incidents compared to historical controls.
3. The intervention will result in shorter overall hospital length of stay compared to historical controls.


Eligibility criteria: Inclusion Criteria:

* Must be evaluated in the psychiatric ED for potential involuntary admission

Exclusion Criteria:

* Not justice-involved (i.e., brought in by police after committing a crime)

Primary outcomes:
measure: ED Time
timeFrame: Patients arrive in the ED at a specific time and leave the ED at a specific time. We will compute the amount of time spent in the ED by each patient, up to two weeks.
Secondary outcomes:
measure: Violent Incidents
timeFrame: Patients arrive in the ED at a specific time. Those who are admitted are eventually discharged. Violent incidents can occur during the entire time spent in the hospital, whether in the ED or on the ward, up to 90 days total.
measure: Hospital Length of Stay
timeFrame: For patients admitted to the hospital through the ED, the beginning time is their arrival to ED, the end is the time of hospital discharge, up to 90 days later.
Other outcomes:
Locations:
city: Afula
country: Israel
facility: HaEmek Medical Center
city: Jerusalem
country: Israel
facility: Jerusalem Mental Health Center - Eitanim
city: Jerusalem
country: Israel
facility: Jerusalem Mental Health Center
city: Pardés H̱anna Karkur
country: Israel
facility: Shaar Menashe Psychiatric Hospital
city: Petah tikva
country: Israel
facility: Geha Psychiatric Hospital
city: Tel Aviv
country: Israel
facility: Tel Aviv Sourasky Medical Center
city: Zefat
country: Israel
facility: Ziv Medical Center
city: Ẕur Moshe
country: Israel
facility: Lev Hasharon Mental Health Center
Study officials:
References: