Edwin D Boudreaux1, Brianna L Haskins2, Celine Larkin3, Lori Pelletier4, Sharon A Johnson5, Barbara Stanley6, Gregory Brown7, Kristin Mattocks8, Yunsheng Ma9. 1. Departments of Emergency Medicine, Psychiatry, and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address: Edwin.boudreaux@umassmed.edu. 2. Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address: Brianna.haskins@umassmed.edu. 3. Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address: Celine.larkin@umassmed.edu. 4. Department of Pediatrics, University of Connecticut School of Medicine, Hartford, CT, USA. Electronic address: lpelletier01@connecticutchildrens.org. 5. Foisie Business School, Worcester Polytechnic Institute, Worcester, MA, USA. Electronic address: sharon@WPI.EDU. 6. Department of Psychiatry, Columbia University, New York, NY, USA. Electronic address: bhs2@cumc.columbia.edu. 7. Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: gregbrow@pennmedicine.upenn.edu. 8. Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address: Kristin.mattocks@umassmed.edu. 9. Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address: yunsheng.ma@umassmed.edu.
Abstract
BACKGROUND: Emergency departments (EDs) are important for preventing suicide. Historically, many patients with suicide risk are not detected during routine clinical care, and those who are often do not receive suicide-specific intervention. The original Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE 1) study examined the implementation of universal suicide risk screening and a multi-component ED-initiated suicide prevention intervention. PURPOSE: The ED-SAFE 2 aims to study the impact of using a continuous quality improvement approach (CQI) to improve suicide related care, with a focus on improving universal suicide risk screening in adult ED patients and evaluating implementation of a new brief intervention called the Safety Planning Intervention (SPI) into routine clinical practice. CQI is a quality management process that uses data and collaboration to drive incremental, iterative improvements. The SPI is a personalized approach that focuses on early identification of warning signs and execution of systematic steps to manage suicidal thoughts. ED-SAFE 2 will provide data on the effectiveness of CQI procedures in improving suicide-related care processes, as well as the impact of these improvements on reducing suicide-related outcomes. METHODS: Using a stepped wedge design, eight EDs collected data cross three study phases: Baseline (retrospective), Implementation (12 months), and Maintenance (12 months). Lean methods, a specific approach to pursuing CQI which focuses on increasing value and eliminating waste, were used to evaluate and improve suicide-related care. CONCLUSIONS: The results will build upon the success of the ED-SAFE 1 and will have a broad public health impact through promoting better suicide-related care processes and improved suicide prevention.
BACKGROUND: Emergency departments (EDs) are important for preventing suicide. Historically, many patients with suicide risk are not detected during routine clinical care, and those who are often do not receive suicide-specific intervention. The original Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE 1) study examined the implementation of universal suicide risk screening and a multi-component ED-initiated suicide prevention intervention. PURPOSE: The ED-SAFE 2 aims to study the impact of using a continuous quality improvement approach (CQI) to improve suicide related care, with a focus on improving universal suicide risk screening in adult ED patients and evaluating implementation of a new brief intervention called the Safety Planning Intervention (SPI) into routine clinical practice. CQI is a quality management process that uses data and collaboration to drive incremental, iterative improvements. The SPI is a personalized approach that focuses on early identification of warning signs and execution of systematic steps to manage suicidal thoughts. ED-SAFE 2 will provide data on the effectiveness of CQI procedures in improving suicide-related care processes, as well as the impact of these improvements on reducing suicide-related outcomes. METHODS: Using a stepped wedge design, eight EDs collected data cross three study phases: Baseline (retrospective), Implementation (12 months), and Maintenance (12 months). Lean methods, a specific approach to pursuing CQI which focuses on increasing value and eliminating waste, were used to evaluate and improve suicide-related care. CONCLUSIONS: The results will build upon the success of the ED-SAFE 1 and will have a broad public health impact through promoting better suicide-related care processes and improved suicide prevention.
Authors: Mark A Ilgen; Maureen A Walton; Rebecca M Cunningham; Kristen L Barry; Steve T Chermack; Peter De Chavez; Frederic C Blow Journal: Suicide Life Threat Behav Date: 2009-10
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