Creation and Implementation of a Multi-Disciplinary Clinical Workflow Aimed at Earlier Diagnostic Evaluation for Autoimmune Encephalitis for Patients Presenting With Atypical Psychosis: A Pilot Study

Objective To implement a clinical workflow that facilitates earlier diagnostic evaluation for autoimmune encephalitis (AE) among patients presenting with atypical psychosis (AP). Background Clinical features found to have positive predictive value AE were recently identified. 1 Early identification of "red flag” was associated 58% reduction in time from symptom onset diagnosis. 2 “Yellow features, while less specific, also AE, especially when multiple present simultaneously. 3 A utilizes these would be significance. Design/Methods We created standardized triage the psychiatric emergency department AP using red/yellow flag features. The presence one or more yellow flags (hyponatremia, first psychotic symptoms at age >40, systemic/infectious prodrome, refractory symptoms, and malignancy history) results neurology consultation. Following consultation, there may recommendation involved testing such as CSF studies, imaging, and/or EEG. red (seizure, dysautonomia, movement disorder, focal finding on neurologic exam) admission service. Results Since implementation February 2022, 5 been All received consultation within 24 hours presentation, after which underwent AE. Conclusions multi-disciplinary is feasible. Preliminary evidence suggests significant decrease presentation compared prior its implementation.