Telepsychiatry to Enable Expedited Disposition of Psychiatric Emergencies

Psychiatric Emergency Clinical Trial

Official title:

Telepsychiatry to Enable Expedited Disposition of Psychiatric Emergencies

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05771545
• Other study ID #: HebrewUJ123
• Status: Recruiting
• Start date: July 1, 2023
• Est. completion date: September 30, 2025

Study information

• Verified date: September 2023
• Source: Hebrew University of Jerusalem
• Contact: Adam J Rose, MD
• Phone: +972555001040
• Email: adam.rose[@]mail.huji.ac.il
• Is FDA regulated: No
• Study type: Observational

Clinical Trial 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.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 800
• Est. completion date: September 30, 2025
• Est. primary completion date: September 30, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

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)

Related Conditions & MeSH terms

• Emergencies
• Psychiatric Emergency

Intervention

Other:
• Telepsychiatry
Instead of coming to the hospital physically, the attending psychiatrist will evaluate the patient via a video-link.

Locations

Country	Name	City	State
Israel	Lev Hasharon Mental Health Center	?ur Moshe
Israel	Jerusalem Mental Health Center	Jerusalem
Israel	Shaar Menashe Mental Health Center	Sha'ar Menashe
Israel	Tel Aviv Sourasky Medical Center	Tel Aviv

Sponsors (1)

Lead Sponsor	Collaborator
Hebrew University of Jerusalem

Country where clinical trial is conducted

Israel, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	ED Time	Amount of time, in hours and minutes, that the patient spends in the ED prior to disposition	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	Violent Incidents	Adjudicated violent incidents that occur, whether in the ED or on the psychiatry ward. Includes hitting, kicking, throwing, and property destruction	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.
Secondary	Hospital Length of Stay	Length of stay, in days, starting with time of arrival to ED	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.