The ACLP is interested in receiving submissions from members regarding the Covid-19 crisis. We are interested in reports on how your institution is changing procedures, including successful and unsuccessful outcomes, policy statements, descriptions of novel approaches, and unexpected problems or barriers encountered. We are interested in case reports, management discussions, and ethical considerations in patient care. We are interested in suggestions about resources useful to clinicians, new developments in regulations, or other material which may be of use to our members providing CL care in the present crisis.
Please send submissions to email@example.com and include a title, author(s), and affiliation(s), and a statement of no conflict of interest (or disclosure of conflict) at the end of your content. All submissions will be peer reviewed promptly per ACLP policy for web content. Accepted items will be posted on the member-submitted resources section of our website. We thank you in advance for your submissions.
Paul Desan, MD, PhD, FACLP, Chair
Ann Schwartz, MD, FACLP, Vice Chair
REPORTS FROM THE FIELD
Education Committee to Seek Information and Resources from Members
The ACLP Education Committee discussed soliciting contributions from members in response to the Covid-19 crisis. Submitted March 14, 2020.
Comments from the Education Committee 031420.pdf
Report from the Brigham and Women’s Hospital Consultation-Liaison Service
Dr. Sejal Shah, MD, FACLP, reports on organizational changes of a consultation-liaison service. Submitted March 24, 2020.
Report from Brigham and Women Hospital 032420.PDF
Report from the University of Illinois College of Medicine at Peoria (UICOMP)
Dr. Andrew J. Lancia, MD, FACLP, reports on organizational changes in a consultation-liaison service. Submitted March 24, 2020.
Report from University of Illinois College of Medicine at Peoria (UICOMP) 032420.PDF
Report from Yale New Haven Hospital
Dr. Paul Desan, MD, PhD, FACL, reports on changes in the Psychiatric Consultation Service as well as changes throughout the hospital. The next link provides our new guidelines for the psychiatric care of patients with definite or possible highly contagious infectious disease. Submitted March 24, 2020.
Report from Yale New Haven Hospital 032420.PDF
Report from NYU Langone Health CL Psychiatry Service
Dr. Caravella and colleagues also provide a Report regarding the situation overall in their service. Submitted March 26, 2020.
NYU CL Service Observations and Response to COVID19 032720.pdf
Guidance for Psychiatry Consults in the ED and CL during COVID19 Pandemic
Dr. Michelle To, MD, Greater Los Angeles VA, CA, provides a manual for consultation in the ED and general hospital. This guidance is for areas where there is no telepsychiatry or other remote access. Submitted March 27, 2020.
Guidance for CL and ED psychiatry consults 032720.pdf
Report from Northwell-Long Island Jewish Medical Center
Dr. Samuel Greenstein, MD, provides an update from this healthcare system on Long Island. Submitted March 27, 2020.
Report from Northwell-Long Island Jewish Medical Center 032720.pdf
Report from The University of Chicago
Dr. Marie B. Tobin MD, FACLP, updates us from her center. Submitted March 28, 2020.
Report from The University of Chicago 032820.pdf
VA San Diego New Policy on Consultations
Dr. Kristin Beizai, MD, VA San Diego Healthcare System, shares their new policies. Submitted March 28, 2020.
San Diego VA CL Service COVID-19 Preparedness Plan 032820.pdf
University of Washington CL Reorganization for Remote Services
Thomas Soeprono, MD, and Amelia Dubovsky, MD, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, suggest ways to split the CL team and use remote methods. Submitted March 29, 2020.
U of W COVID CL preservation plan 032920.pdf
NYU Langone Hospital ED Policy for Consultations
Drs. Rachel Anne Caravella, MD, and Maureen Martino, MD, NYU Langone Medical Center, provide their new ED policy. Submitted March 29, 2020.
NYU Langone Hosp Perelman ED COVID 19 Planning Psychiatry Protocol 032920.pdf
Covid-19 and Factors Affecting Immune Response
Dr. Karen Lewicki, MD, JD, of the White River Junction VA Medical Center, VT, provides a slide presentation on the immune response to Covid-19 and the effect of psychosocial and other factors on that response. Submitted April 1, 2020.
COVID-19 and immune considerations 040220.pdf
Report from Elmhurst Hospital Center Consultation-Liaison Psychiatry
Dr. Shruti Tiwari, MD, Icahn School of Medicine at Elmhurst Hospital Center, Queens, NY, provides an update from a hospital hard-hit in the present crisis. Submitted April 1, 2020.
Report from Elmhurst NY 040120.pdf
Report from Madrid, Spain
Dr. Celso Arango, MD, Department of Child and Adolescent Psychiatry; Hospital General Universitario Gregorio Marañon, in Madrid, Spain, provides a report regarding desperate circumstances in that city. This report has many implications for those planning services in American cities. Submitted April 2, 2020.
Report from Madrid Spain 040220.pdf
Report from Northwell-Long Island Jewish Medical Center, Updated
Dr. Damir Huremović, MD, MPP, FAPA, FACLP, of North Shore University Hospital, Manhasset, NY, provides an eloquent update from the Northwell system. Submitted April 4, 2020.
Report from Northwell-Long Island Jewish 040320.pdf
AACAP Resources on Talking to Children about Sick Adults
Dr. Maryland Pao, MD, FACLP, and the ACLP Pediatric C-L Psychiatry SIG provide this list of resources created by the AACAP Physically Ill Child Listserv. Submitted April 5, 2020.
AACAP Resources for Talking with Children About Illness 040520.pdf
Report from Mount Sinai Beth Israel, New York, NY
Dr. Seema Quraishi, MD, of the Icahn School of Medicine at Mount Sinai, provides a report from Mount Sinai Beth Israel in NYC. Submitted April 5, 2020.
Report from Mount Sinai Beth Israel New York NY 040520.pdf
Drs. Seema Quraishi, MD, and Carmen Casasnovas, MD, provide a detailed protocol for CL psychiatry, including the use of remote consultation with iPads.
Mount Sinai Beth Israel CL Psychiatry COVID-19 Guidelines 040520.pdf
UCSF Child and Adolescent Psychiatry CL Care Algorithm
Dr. Khyati Brahmbhatt, MD, Child and Adolescent Psychiatry Consultation-Liaison Service (PPACT), UCSF, provides their algorithm for case triage. Submitted April 7, 2020.
UCSF Child and Adolescent Psychiatry CL Care Algorithm 040720.pdf
Comments on Psychiatric Humility in the Covid-19 Era
Drs. Thomas Soeprono, MD, and R. Michael Huijon, MD, Department of Psychiatry, University of Washington, Seattle, urge careful consideration of direct patient contact in the current crisis. Submitted April 8, 2020.
U of W Psychiatry in the Era of COVID-19 040820.pdf
Effects of IL-6 Antagonism on Mental State
With increased use of tocilizumab in the treatment of Covid-19 infection, we recall that ACLP member Jennifer Knight, MD, described an increased level, rather than the anticipated decreased level, of depression in patients treated with this agent (as described in her ACLP Webinar in September 2019).
ACLP Submission Jennifer Knight MD on tocilizumab and depression 2018.pdf
Report from King Chulalongkorn Memorial Hospital, Bangkok, Thailand
Dr. Paul Thisayakorn, MD, provides this account of operational challenges at their hospital as the Covid-19 crisis worsens in Thailand. Submitted April 10, 2020.
Report from King Chulalongkorn Memorial Hospital Bangkok 0401020.pdf
Report from Montefiore Medical Center, Bronx, NY
Dr. Mary Alice O’Dowd, MD, FACLP, Psychosomatic Medicine, Montefiore Medical Center, Bronx, NY, updates us regarding their consultation service. Submitted April 10, 2020.
Report from Montefiore Medical Center Bronx NY 041020.pdf
Alternatives to Parenteral Lorazepam in Face of Possible Shortage
Dr. Seth Powsner, MD, FACLP, Department of Psychiatry, Yale School of Medicine, New Haven, CT, provides a memo regarding alternatives to parenteral lorazepam for acute agitation. Submitted April 10, 2020.
Alternatives to parenteral lorazepam 041020.pdf
Sanctuaries for High-Risk Groups and Solidarity Teams
Drs. Ricardo Millán-González, MD, and Óscar Monge-Navarro, MD, argue that society must organize to isolate elderly and vulnerable individuals, including formation of “solidarity teams.” Submitted April 16, 2020.
Sanctuaries and solidarity teams 041620.pdf
University Health Network Centre for Mental Health COVID-19 Screening and Isolation Algorithm
Dr. Lindsey MacGillivray, MD, PhD, FRCPC, University of Toronto, Toronto, Canada, sends an algorithm for assessment and triage of Covid-19 patients. Submitted April 16, 2020.
University Health Network Covid Screening and Isolation Algorithm 041620.pdf
ACLP member Dr Madeleine Fersh, MD, FACLP, of the Long Island Jewish Medical Center, NY, describes her experiences as a Covid+ patient in a piece just accepted to Psychosomatics.
Report from the Memorial Sloan Kettering Cancer Center
Dr Christian Bjerre Real, MD, MMCI, and colleagues at the Memorial Sloan Kettering Cancer Center, NY, NY, send an update, and three clinical protocols. Submitted April 17, 2020.
Updated Guidelines for sedation as of May 26 are provided below in a subsequent submission from MSKCC.
Report from the MSKCC Psychiatry Service 041720.pdf
MSKCC Revised Suicide Practice 041720.pdf
Report from Northwell-Long Island Jewish Medical Center, Further Updated
Dr. Damir Huremović, MD, MPP, FAPA, FACLP, of North Shore University Hospital, Manhasset, NY, provides another eloquent update from the Northwell system, accompanied by two flowcharts regarding the management of agitation and anxiety. Submitted April 19, 2020.
Report from Northwell-Long Island Jewish 041920.pdf
Northwell-Long Island Jewish Flowchart Management of agitation & delirium 041920.pdf
Northwell-Long Island Jewish Flowchart Management of Anxiety 041920.pdf
Report from University Medical Center, New Orleans, LA
Drs. Erich J. Conrad, MD, FACLP, and B. Lochlann McGee, MD, Louisiana State University School of Medicine, describe changes in C-L operations in their front-line hospital. Submitted April 20, 2020.
Report from University Medical Center New Orleans 042120.pdf
Checklist for Starting a New Rotation
Since protocols and procedures are changing rapidly, Dr David P. Kasick, MD, Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, suggests a checklist for staff or residents starting a new rotation. Submitted April 23, 2020.
Ohio State Univ CLP Resident Onboarding Checklist 042320.pdf
Report from the Medical University of South Carolina
Edward M. Kantor, MD, of the Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, sends us this update which includes extended discussion of remote consultation methods. Submitted April 23, 2020.
Report from the Medical University of South Carolina 042320.pdf
Dr Kantor and colleagues provide additional detail about the conversion to telepsychiatry. Submitted May 7, 2020.
MUSC Transition to Telepsychiatry 050820.pdf
Assessing Capacity for Medical Decisions in the Covid-19 Context
Elizabeth Ryznar, MD, MSc, Dept of Psychiatry & Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, MD, and R. Brett Lloyd, MD, PhD, Dept of Psychiatry & Behavioral Sciences, Northwestern University, Chicago, IL, provide a PowerPoint presentation about decisional capacity and Covid-19. Submitted May 4, 2020.
Johns Hopkins Capacity and Covid Pandemic 050420.pdf
Report on Proactive Telephonic Visits to Support Patients Admitted with COVID-19
Joy J. Choi, MD, and Mark V. Bradley MD, FACLP, of the Veterans Affairs New York Harbor Healthcare System, NYU School of Medicine, NY, NY, describe an innovative proactive approach to providing daily support and assessment by telephone to admitted Covid-19 patients. Submitted May 11, 2020.
NYU VA Proactive Telephonic Visits to Support Patients Admitted with COVID-19 051120.pdf
Report from the West Virginia University Cancer Institute: Psycho-Oncology in Covid-19 Times
Dr. Kaleena Chilcote, MD, Departments of Behavioral Medicine and Psychiatry and Internal Medicine, West Virginia University School of Medicine, Morgantown, WV, reports from the Cancer Canter. Submitted May 22, 2020.
Report from West Virginia University Cancer Institute 052220.pdf
Report from Northwell-Long Island Jewish Medical Center, Update of May 22, 2020
Dr. Damir Huremović, MD, MPP, FAPA, FACLP, of the Dept of Psychiatry, North Shore University Hospital, Manhasset, NY, provides another striking update as the medical center moves towards resuming normal operations. Submitted May 22, 2020.
Report from Northwell Long Island Jewish 052220.pdf
Report from the Memorial Sloan Kettering Cancer Center, Update of May 26, 2020
Dr. Yesne Alici, MD, FACLP, and colleagues at the Memorial Sloan Kettering Cancer Center, NY, NY, send an updated report from their center, and expanded protocols for sedation in the Covid-19 patient. Submitted May 26, 2020.
Report from the MSKCC Psychiatry Service 052620.pdf
MSKCC Sedation and Delirium Guidelines for Critically Ill 052620.pdf
Report from Baylor Scott & White Health Psychiatry: Using a Public Health Crisis to Accelerate Modernisation
Dr. James A. Bourgeois, OD, MD, FACLP, of the Department of Psychiatry, Baylor Scott & White Health, Temple, TX, describes a rapid transformation to virtual medicine in all departmental sectors, noting that the Covid-19 crisis has done more to advance telemedicine than any other recent influence. Submitted July 26, 2020.
Report from BSWH Psychiatry 072620.pdf
EDUCATION IN THE COVID-19 CRISIS
Remote Learning Resources Suggested by the ACLP Residency Education Subcommittee
Dr. Carrie L. Ernst, MD, offers a list of learning resources that may be of use to residents working from home, on behalf of the Residency Education Subcommittee. Submitted March 29, 2020.
Residency Education Subcommittee CL Psychiatry Remote Learning Resources 032920.pdf
How to Maintain Moral and Cohesion for Your CL Team During the COVID-19 Pandemic
Dr. Carrie L Ernst, MD, Mount Sinai Hospital, New York, NY, comments on strategies to maintain team morale, especially for trainees, in the current crisis. Submitted April 16, 2020.
How to Maintain Morale and Cohesion for your CL team during the COVID 041620.pdf
Virtual Interviews in the Era of COVID-19: A Primer for Applicants
Ruth Ellen Jones, MD, and Kareem R. Abdelfattah, MD, offer advice for virtual interviewing, which will certainly be relevant for fellowship applications this year.
AAMC, ACGME, AMA, and Other Organizations Recommend Virtual Residency Application Interviews
The inter-organizational Coalition for Physician Accountability’s Work Group on Medical Students in the Class of 2021 Moving Across Institutions for Post Graduate Training has recommended that all interviews this year for applicants to residency be virtual. Virtual interview tips for Program Directors from the AAMC are also provided.
Coalition Final Recommendations Covid 19 Work Group 051120.pdf
AAMC Virtual_Interview_Tips_for_Program_Directors 051120.pdf
Virtual Interviewing for Residency Programs
The University of Arizona College of Medicine – Phoenix has substantial experience in virtual interviewing for residency positions and has produced a detailed one-hour video manual on their method.
ACLP Program Directors Web Forum on May 20, 2020
Drs. Lisa Rosenthal, MD, FACLP, Mark Bradley, MD, FACLP, Carrie Ernst, MD, Raymond Young, MD, Durga Roy, MD, and Kewchang Lee, MD, FACLP, discuss changes to fellowship program operations in the present crisis, including expectations that all recruitment interviewing this year will be virtual.
TELEPSYCHIATRY RESOURCES AND REMOTE CONSULTATION TECHNOLOGY
Guidance about Telepsychiatry for the Covid-19 pandemic
Dr. Terry Rabinowitz MD, DDS, FACLP, provides up-to-date guidance about telepsychiatry and specific hints and tips.
Telepsychiatry in the Covid pandemic 032520.pdf
Telehealth Attending Provider Manual from University of Washington Medicine
Amanda Focht, MD, Denise Chang, MD, Cara Towle, RN, MSN, Jay Wellington, MSW, LICSW, Laurel Pelligrino, MD, Jen Erikson, DO, Ryan Kimmel, MD, and Tom Soeprono, MD, provide a superb and detailed 36-page manual for telepsychiatry. This is a special resource provided by the University of Washington Medicine to assist facilities in rapid implementation of telehealth services in the present emergency.
University of Washington Telehealth Attending Provider Manual 032020.pdf
NYU Langone Health TELE Consultation Manual and Report
Dr. Rachel A. Caravella, MD, Allison B. Deutch, MD, Paraskevi Nouslas, PsyD, and David Ginsberg, MD, of the NYU Langone Health system report on using remote technology to perform consultations. The system uses tablets that are built into patient tray tables, as well as tablets that were purchased locally to aid in the crisis. Submitted March 26, 2020, updated April 3, 2020.
NYU Langone Health TELE Consultation protocol 032620.pdf
How to Use IPads for Patient Communication
Drs. Victoria Nettles, MD, and Blair Walker, MD, provide a guide to setting up iPads for use in patient communication. Submitted April 9, 2020.
U of T Austen Tele iPad Setup 040920.pdf
Yale New Haven Hospital Training on Televisits using Epic and Haiku / Canto
This PowerPoint shows the steps in using these Epic-based apps for remote visits. Submitted April 10, 2020.
Yale New Haven Telehealth Notes for Epic Canto & Haiku 041020.pptx
Report on Conversion to Telepsychiatry at the VA System from Palo Alto, CA
Dr. Divy Ravindranath, MD, MS, FACLP, reports on converting to telepsychiatry in a system of VA facilities in the Bay Area. Submitted March 24, 2020.
COVID and conversion to telepsychiatry in VA inpatient hospital Military and Veterans SIG Skype Meeting 032420.PDF
University of Pittsburgh Medical Center Manual for Video Consultations
Dr. Priya Gopalan MD, FACLP, provides a detailed manual for video CL The manual is authored by Sharon Altman MD; Morgan Faeder MD PhD; Daniel Fishman; Priya Gopalan MD; Shelly Kucherer MD; Michaelene Landy APRN; Darcy Moschenross MD PhD Alexis Pape MA; Gina Perez MD; Sharvari Shivanekar MD; Meredith Spada, MD, Med, of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, 15206-4206 United States. Submitted March 26, 2020.
University of Pittsburgh Medical Center COVID19 CL COVID MANUAL 032620.pdf
Additionally, Laurel Pellegrino, MD, and Thomas Soeprono, MD, of the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, offer tips for telepsychiatry services. Submitted March 29, 2020.
U of W Tele Tips during COVID 032920.pdf
All authors have indicated an absence of conflict of interest with regard to their submission (or indicated any potential conflict within the content).