I’m standardizing my 20‑minute same‑day consults and currently use PHQ‑9, GAD‑7, and the C‑SSRS, followed by a brief safety plan and a starter behavioral activation task. If you’ve got concise flows or templates (Epic SmartPhrases, MI prompts, safety plan handouts) that help you fit assessment and intervention into these tight visits, would you share what’s in your kit and how you structure it?
I use a single Epic SmartPhrase (.PSY20MIN) that auto-pulls PHQ‑9/GAD‑7, the C‑SSRS tier, and drops three MI prompts including “On a 0–10 scale, how ready are you to try one 10‑minute activity this week?”, plus a safety plan link I can fill on the fly (VA template: https://www.mentalhealth.va.gov/docs/safety-planning/SafetyPlanTemplate.pdf). Tiny caveat: on ultra‑packed visits I swap BA for a one‑liner — “identify one support + one trigger” — so I’m not playing chart whack‑a‑mole.
Piggybacking on @jcollins48’s SmartPhrase, I added.P4SUICIDE to run the P4 right after C-SSRS and auto-fill a one-liner plan — ‘means checked, coping x1, contact x1, f/u 48h’ — and it drops a BA menu link (https://www.therapistaid.com/worksheets/behavioral-activation); if it’s a crisis, I skip the BA and just do the safety steps.
Quick tweak that saved me time: my dotphrase turns PHQ‑9 item 9 plus the suicide screen result into a two‑click safety block and auto-drops one BA task to the AVS; @derek_h89 inspired the flow, and on low‑risk days I’ll swap BA for a 60‑second sleep reset so it still fits the 20‑minute slot.
I added a SmartLink at the top that shows PHQ-9/GAD-7 change from last visit and it tees up a 20-second check-in: “What changed most since last week?” Then a tiny SAFE-T SmartText turns the Columbia result into a single risk line and prints crisis info + the one BA step to the AVS; downside is it’s wordy by default, so I trimmed it to 6th-grade reading.
I built a.RISKSUM SmartPhrase that turns “PHQ‑9 item 9” plus the C‑SSRS level into a one‑line risk summary (adds 1–2 protective factors) and auto‑drops a brief means‑safety/988 note to the AVS. Small caveat: on telehealth I use P4 first and only expand to C‑SSRS if it pings — want the snippet?
I add a 10‑second bipolar check before meds: “any past week with much less sleep and still wired?” and “a stretch of feeling unusually energized plus risky spending/sex/driving?” If either’s yes, I hold the antidepressant and pivot to brief risk/means safety and a tiny activation goal — little guardrail that’s saved me from oops moments. @mray34 your change‑from‑last‑visit cue pairs well with this in tight visits.
Piggybacking on @sarahm_2419, I use an Epic.PSYCH20 SmartPhrase that auto-pulls PHQ-9/GAD-7, drops ‘top 2 problems today,’ a one-line risk/protective note, and two MI prompts — ‘what matters most right now?’ and ‘one small step before we meet again?’ to keep me under the 20-minute speed limit. If I’m slammed, I swap BA for a single ‘5-minute activity + when/where + who’ and send Learn Skills — Now Matters Now as homework.