For DONs, ADONs, social services, and MDS
What actually happens on your floor when the clinic is running
You carry the resident between visits. This page is about what we take off your list, what we don't, and how a recommendation becomes an order.
Wait times
A standing weekly slot instead of a consult that's "pending"
Initial evaluations and follow-ups go on the weekly clinic list your coordinator builds. Urgent clinic questions about a resident already on the panel are triaged into the next available slot. We don't publish a turnaround number, because a number we can't keep on a bad week is worse than the honest version — a clinic that shows up every week.
During scheduled coverage
Four situations, and what we do with each
New hallucinations or a severe behavioral change
The coordinator flags the resident; we move them into the next clinic slot and read the chart first — new medications, infection signs, pain, sleep, the last labs. Delirium gets asked about before a psychiatric label gets attached. If the situation is unsafe now, your emergency process runs, not ours.
Suicidal thinking
Facility safety procedures come first, immediately. On the clinic side the resident is assessed by a licensed clinician, a documented safety plan goes to nursing and the attending, and the follow-up interval is set by risk, not by the calendar.
A suspected medication adverse effect
Falls, sedation, a movement change, a QT question, new confusion after a dose change. We review the eMAR and the timeline, and the recommendation to the attending names the suspected agent and the alternative, with the reasoning written down.
A PRN that keeps getting renewed
We evaluate the resident and document the indication, whether the PRN is still clinically appropriate, and what should replace it if it isn’t. Either way the chart shows an evaluation instead of a renewal.
Between clinics, emergencies are 911, the attending, and transfer — your process, unchanged.
Implementation
How a recommendation becomes an order
The signed note goes to the attending and nursing through your routing. The attending keeps authority over the orders; we don't write around them. The coordinator keeps the open items — a lab, a change to implement, a behavior plan — and we check each one at the next clinic. If a recommendation isn't implemented, that's a conversation, not a silent gap in the chart.
Indication, GDR, and PRN review
Clinical support for a chart that has to defend itself
Every psychotropic gets a documented indication. Every GDR question gets a clinical answer — appropriate, or contraindicated and why. Every renewed PRN gets an evaluation. That's the clinical evaluation your pharmacist's recommendations need behind them, written by a clinician who saw the resident.
It is not a promise about a survey. Nobody can make that promise honestly, and we'd rather you hear that from us.
Talk to us about coverage
Approximate licensed beds, average census, and how psychiatry is covered today are enough to start. Leave resident names, diagnoses, and chart details out until the agreement and BAA are signed. We'll tell you on the first call whether the model fits your building.
Scheduled coverage — not a 24/7 emergency or onsite hospitalist service. Your emergency process stays your emergency process.