SMART Medical Clearance Form

The Sierra Sacramento Valley Medical Society (SSVMS) brought together specialists in the fields of emergency and psychiatry to develop and implement a standardized medical clearance process using the SMART Medical Clearance algorithm.

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SSVMS Emergency Care Committee

SSVMS convened the Emergency Department Medical Directors from all 14 regional hospitals in the Sacramento area to assess overcrowding in the ED.

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Crisis in the Emergency Department

SSVMS published a white paper, Crisis in the Emergency Department: Removing Barriers to Timely and Appropriate Mental Health Treatment (July, 2015), to address the increase in the number of patients in mental health crisis in the region's emergency departments.

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SMART Medical Clearance: A Community Collaboration

Patients in mental health crisis frequently present to Emergency Departments (EDs) for medical evaluation and treatment. The frequency of organic etiologies driving their presentations are variable yet identifiable if standardized screening protocols are used. Unfortunately, in most systems, patients are medically screened by the blind ordering of diagnostic “psych panels” thereby adding unnecessary testing to an already inefficient system. This practice leads to overutilization, overtreatment, extended wait times, increased lengths of stay, increased suffering and higher risks of adverse outcomes for all ED patients, not just psychiatric patients.

To help alleviate this problem, the Sierra Sacramento Valley Medical Society (SSVMS) convened emergency medicine physicians and psychiatrists to implement the SMART Medical Clearance protocol to standardize the medical clearance process across all EDs and inpatient psychiatric hospitals with the goal of improving the quality of care for patients in crisis.  The SMART protocol facilitates the safe and timely transfer of patients to appropriate treatment centers in a resource-conscious way by relying on evidence based medicine and thorough bedside exams. Learn More Here.