Clinical Training

The primary training clinical programs for residents and medical students are as follows:

Inpatient. Inpatient training occurs on a 24-bed unit staffed with 2.25 FTE. Three residents are each assigned to a team of eight patients. The faculty is on the unit 5 to 7 hours each day and this is their only clinical assignment for the department, thus assuring attending availability all day for the residents and medical students. Medical students are assigned to this unit as well as the other two acute inpatient units of which there are two attendings on each unit. For these attendings the inpatient unit is the primary clinical assignment for the department.

Crisis Response Center. This is the psychiatric emergency service which is open 24/7 all year. It is staffed during the day by 2 attending physicians and in the evening by moonlighting faculty. Faculty also provide onsite coverage on Saturdays and Sundays during the day. The 8 a.m. to 9 p.m. hours are covered by three residents with the third resident starting at 1 p.m.. Evenings and nights are covered by 2 residents from 9 p.m. until 8 a.m. An attending is always on call and available by phone at night. Medical students are also assigned to the Crisis Service and rotate from 8 a.m. until 5 p.m. and then all medical students work in a rotation in the evening from 5 p.m. until 11 p.m.

Consultation and Liaison Service. The service is located at Temple University Hospital which is a 601-bed teaching hospital for Temple University School of Medicine. This service is staffed by two attendings. Two residents are assigned each rotation and 2 or 3 medical students are assigned. A third attending provides consultation to the transplant services for the equivalent of a .25 FTE. A PhD licensed psychologist for the department provides another 10-12 hours week support to the transplant services.

Outpatient Services. The outpatient services are located in the Medical Arts Building which is adjacent to Episcopal Hospital. This newly refurbished space has offices with large bay windows for each resident. Usually six residents a year are assigned to the outpatient service. The Medical Director for the service is assigned full time and has an office adjacent to the residents. In addition four other faculty members have offices in the outpatient suite so that attendings are always available to residents. Two of the faculty members in the outpatient suite are child and adolescent psychiatrists and provide onsite supervision when the need arises. Medical students are not assigned to the outpatient department. The outpatient department also has video capabilities and two way mirrors for teaching purposes.

Clinical Programming

In collaboration with the Office of Mental Retardation of Philadelphia, Temple University Hospital Episcopal Campus has developed a special inpatient program for patients with mental retardation. The program is so highly regarded that the program regularly receives requests from families outside of Philadelphia County because they state that they have heard about the program.

One of the most innovative programs developed at Temple University Hospital Episcopal Campus has been the pharmacy program, which is a collaborative effort between the inpatient program and a neighborhood pharmacy, Philadelphia Pharmacy, to provide all patients with their medication before they are discharged from the hospital. To facilitate this, a meeting was held with six pharmaceutical companies to make coupons available for patients who have no health insurance or whose insurance has no or limited pharmacy benefits. The coupons provide from 5 to 30 days of free medication. Since this program was initiated in April 2004, an additional two pharmaceutical companies have made coupons available. The day prior to discharge the patient’s prescriptions are sent to the pharmacy and medications are delivered to the patient’s unit by 10 a.m. the next day. This program was described in the September 10th edition of the Philadelphia Business Journal.

The Extended Acute Care Program was completely revised to be even more therapeutic to prepare patients for discharge. An internationally recognized expert in psychosocial rehabilitation and psychosocial education, Susan Gingrich, MSW, was engaged to restructure our Extended Acute Care Program and provide ongoing training and mentoring to all staff. The therapeutic approach on the unit now focuses on psychosocial rehabilitation and recovery groups.

In August 2004, a major programming change was implemented in the Crisis Response Center. A 23-hour, 6-bed observation program was started in cooperation with CBH. This is the first Crisis Response Center in Philadelphia and the first clinical program in Philadelphia to have a 23-hour bed program in the Crisis Response Center. To date, this has been highly successful with an 80% diversion rate of patients from acute inpatient hospitalization.

Weight loss education and smoking cessation programs were implemented for all inpatients at TUH-EC. A multidisciplinary task force developed these programs, which are part of the Performance Improvement (PI) program. The focus is on identification and education of patients who are overweight or addicted to nicotine on the acute units with appropriate outpatient follow up to treat these problems. The Extended Acute Unit provides treatment and designated outcome parameters measure the success of the program.

Awards

Philadelphia Magazine recognized the behavioral health programs as a Center of Excellence in March 2003

Press Ganey 2005 Compass Award for greatest improvement in patient satisfaction scores in a one year period

StuderGroup Fire Starter Award 2006 for outstanding employee and patient satisfaction

Summit Award 2008, given by Press Ganey to hospitals who have been at the 95th percentile every quarter for at least 3 years

Brighter Futures Award November 2009, presented by the Philadelphia County department of Mental Retardation for “helping patients with developmental disabilities and co-occurring behavioral health needs achieve positive outcomes"

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