AMA Form Against Medical Advice | Medical Algorithm

Are you evaluating a patient admitted to the psychiatric unit of a hospital?

Yes

Gender of the patient

Male

Female

Number of inpatient psychiatric admissions prior to this one

Does the patient have a functional impair-ment due to physical illness?

Yes

Does the patient live alone?

Yes

Is the patient employed?

Yes

Select an appropriate answer for each finding

Ethnicity

Substance abuse problem

Suicidality on admission

Uncooperativeness

Level of denial during hospitalization

Results

Please fill out required fields.

Results Interpretation and Description References Next Steps

Data complete?

Evaluation appropriate?

Number of predictors for leaving AMA

Number of other factors present that are associated with leaving AMA

Should early discharge planning be a priority for this patient?

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Severity, Prognosis, Stage
- Screening Tool for Early Discharge Planning

Therapy

Selection
- Screening Tool for Early Discharge Planning

Monitoring

Compliance/adherence

Patient Concerns

Disability And Performance
- Early Screen for Discharge Planning (ESDP) of Holland et al
- Evaluating Patient's Understanding of Diagnoses & Treatment Plan at Discharge
Psychological Response
- Handling Patient Leaving Hospital Against Medical Advice (AMA)

Evaluation

Results

Please fill out required fields.

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Therapy

Monitoring

Patient Concerns

Objective

ICD-10

Model for Prediction of Psychiatric Patient Leaving AMA

Purpose: To identify a patient admitted to the psychiatric unit who is more likely to leave against medical advice (AMA) based on the model of Pages et al.

Evaluation

Results

Please fill out required fields.

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Therapy

Monitoring

Patient Concerns

Objective

ICD-10