Proactive Psychiatric Consultation For Hospitalized Patients, A Plan for the Future

The Yale Behavioral Intervention Team (BIT) is a proactive, multi-disciplinary psychiatric consultation service for all internal medicine inpatients at Yale-New Haven Hospital. The goal of the team, which includes nurses, social workers, and psychiatrists, is to shift from a “reactive” to a “proactive” paradigm of psychiatric consultations on hospital inpatient medical floors. The team screens for, identifies, and removes/mitigates behavioral barriers to the effective receipt of health care among hospitalized medical patients, especially among those with co-occurring mental illness and/or substance abuse. To facilitate delivery of timely, effective inpatient medical care, the BIT collaborates closely with the medical team through formal and informal advice, co-management of behavioral issues, education of medical, nursing, and social work staff, and direct care of complex

Developing Standards ‘Of, By, And For’ Older Adults: Reflections On Patricia Gabow’s Narrative Matters Essay

Imagine three people: a healthy 30-year-old, a 60-year-old with high blood pressure, diabetes and arthritis, and a 90-year-old who is frail and has dementia advanced to the point where her speech often doesn’t make sense. If I lined them up, any doctor could instantly tell me which was which. Ditto if each broke a bone and I showed the physicians only their x-rays. And if I asked the clinicians to predict each patient’s risk of complications and adverse events based on nothing more than the few words above, they would again rapidly and reliably make accurate assessments. Yet, for the most part, our health system lumps these three people into a single “adult” category, an approach that flies in the face of anatomy,