Seattle University Collaborative Projects - International Academy of ...

Patient Safety in Psychiatry: Clinical Issues and Risk ManagementJacob C. Holzer, Pocasset Mental Health Center, Pocasset, USA(Jacob.holzer@dmh.state.ma.us)Medical errors and the potential for harm to patients exist in the fields of medicine andpsychiatry. As advances in the understanding and treatment of illnesses have been made,morbidity and mortality from disease has decreased. However, simultaneously, as treatmentshave become more varied and complex, morbidity and mortality from treatment has increased.The costs of errors include spending in the billions of dollars, increased lengths of stay in thehospital, and increased re-admissions, along with patient morbidity and mortality. There arenumerous causes of error, including human error, the complicated nature of medicine, andsystemic issues. As both direct care staff have more patients to care for, and non-direct care staffhave increased, so too have errors. This presentation will identify and review sources anddemographics of error, individual and system functions, communication, and areas ofimprovement in clinical psychiatric evaluation and management aimed at reducing error and risk,within the context of forensic psychiatry and risk management.Safe Patient Management in Geriatric Psychiatry: Issues inPsychopharmacological ManagementRobert Kohn, Brown University (robert_kohn@brown.edu)There are no FDA psychopharmacological agents approved for use in managing any behavioralproblem in Alzheimer’s disease. Antipsychotics are not FDA approved for treatment ofpsychosis or agitation in dementia. The black box warning for early mortality andcerebrovascular events places the clinician in a difficult situation in dealing with any geriatricpatient who may have behavioral issues that are not manageable with other alternatives. Thephysician treating an elderly patient with antipsychotic medications needs to weigh ethical andregulatory issues in prescribing, in the face of data questioning not only safety, but also efficacy,of antipsychotic medications. This presentation will review the controversy, the appropriate useof antipsychotic medications, and treatment alternatives to antipsychotics. In addition, the morerecent issues around SSRI safety, the use of cognitive enhancers, and other pharmacologicalagents will be discussed.Quality Control and Process Improvement Techniques for OutpatientPsychiatric PracticeRobert P Granacher, Jr, University of Kentucky (rgranacher@aol.com)254