Psychiatric Plan

Impression: [textarea name="Impression"]

Safety Assessment: [checkbox name="Safety" value="Suicidal ideations with plan|Suicidal ideations without plan|No SI|Homicidal ideations|No HI|Command Auditory Hallucinations|Non-command AH|No AH|Visual Hallucinations|No VH|Poor supports|Poor services"]

Plan: [textarea name="Plan"]

Admission Management:
- Admission date: [text name="date"]
- Admit to service of [select name="physician" value="Dr. Snow|Dr. Strazisar|Dr. Figueroa|Dr. Sinha"]
- Status: [select name="Status" value="201|302"]
- [checkbox name="CLevel" value="C.1|C.2|C.3|Roommate Ok|Roommate Inappropriate"]
- Encourage participation in therapeutic milieu

Psychiatric Management:
[textarea name="psychmanagement"]

Medical Management:
- Pt received medical clearance by ED physician
- Routine labs ordered on admission: CBC, CMP, TSH, HbA1c
- Medical service consulted for comanagement
- Resumed home medications:


Discharge Management:
- Social Work consulted for resource organization and disharge planning
- [select name="guardian" value="Legal guardian:|POA:|Parent:|Person to contact:"] [text name="Name"]
- Living: [text name="housing"]
- [select name="external" value="School:|Work:|No school or work"]
- Outpatient services:
    - Psychiatrist: [text name="psych"]
    - Therapist: [text name="therapy"]
    - PCP: [text name="pcp"]
    - Pharmacy: [text name="pharmacy"]
Impression:


Safety Assessment:

Plan:


Admission Management:
- Admission date:
- Admit to service of
- Status:
-
- Encourage participation in therapeutic milieu

Psychiatric Management:


Medical Management:
- Pt received medical clearance by ED physician
- Routine labs ordered on admission: CBC, CMP, TSH, HbA1c
- Medical service consulted for comanagement
- Resumed home medications:


Discharge Management:
- Social Work consulted for resource organization and disharge planning
-
- Living:
-
- Outpatient services:
- Psychiatrist:
- Therapist:
- PCP:
- Pharmacy:

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.38, 16 form elements, 83 boilerplate words, 7 text boxes, 3 text areas, 2 checkboxes, 4 drop downs, 31 total clicks
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