TY - JOUR
T1 - From Pilot to Practice
T2 - Implementation of a Suicide Risk Screening Program in Hospitalized Medical Patients
AU - Snyder, Deborah J.
AU - Jordan, Barbara A.
AU - Aizvera, Jeasmine
AU - Innis, Marilyn
AU - Mayberry, Helen
AU - Raju, Minnie
AU - Lawrence, Diane
AU - Dufek, Anne
AU - Pao, Maryland
AU - Horowitz, Lisa M.
N1 - Funding Information:
Elizabeth Ballard, Julie Kohn-Godbout, Jeanne Radcliffe, Gwenyth Wallen, Kathy Baxley, Laura Lee, Mary Bowes, Robert Cox, Ellen Eckes, Caroline Frazier, Raymond Nudo, Leslie Smith, William Booker, Eliza Lanzillo, Daniel Powell, Jarrod Smith, Mary Tipton, Annabelle Mournet. The authors would like to thank the National Institutes of Health Clinical Center nurses, social workers, and psychiatrists for the ongoing participation in this work. This research was supported in part by the Intramural Research Program of the National Institute of Mental Health (Annual Report Number ZIAMH002922).
Publisher Copyright:
© 2020
PY - 2020/7
Y1 - 2020/7
N2 - Introduction: Hospitals have become an important venue for identifying medical patients with occult suicidality. This article describes the implementation of a quality improvement project at the National Institutes of Health Clinical Center (NIHCC) to systematically screen medical/surgical inpatients for suicide risk. Methods: Using the Plan-Do-Study-Act method, questions from the Ask Suicide-Screening Questions (ASQ) tool were deployed with medical inpatients aged 10 years and older between April 2018 and April 2019. Goals included the development of a training program, policy and procedure review, electronic medical record integration and data collection, and ongoing management and troubleshooting. Results: A total of 4,284 patients were screened for suicide risk with a nurse screening compliance rate of 94.3%. Prevalence data on patients aged 10 years and older revealed an overall screen positive rate of 2.3% (97/4,284), with 3.1% of youth aged 10 to 24 years and 2.2% of adults screening positive. Of the 97 patients who screened positive, 96 were non-acute positive screens. Of the full sample, only 1 patient (0.02%) was deemed acute positive, requiring a 1:1 observer and full safety precautions. Conclusion: Universal suicide risk screening was successfully implemented in the NIHCC without incurring a need for additional resources. The intermediate step of a brief suicide safety assessment is a critical part of the workflow, providing guidance for determining appropriate follow-up in a safe and efficient manner that spares limited mental health and hospital resources. Given the increasing suicide rates in the general population, medical venues offer important opportunities for early detection, assessment, and referral.
AB - Introduction: Hospitals have become an important venue for identifying medical patients with occult suicidality. This article describes the implementation of a quality improvement project at the National Institutes of Health Clinical Center (NIHCC) to systematically screen medical/surgical inpatients for suicide risk. Methods: Using the Plan-Do-Study-Act method, questions from the Ask Suicide-Screening Questions (ASQ) tool were deployed with medical inpatients aged 10 years and older between April 2018 and April 2019. Goals included the development of a training program, policy and procedure review, electronic medical record integration and data collection, and ongoing management and troubleshooting. Results: A total of 4,284 patients were screened for suicide risk with a nurse screening compliance rate of 94.3%. Prevalence data on patients aged 10 years and older revealed an overall screen positive rate of 2.3% (97/4,284), with 3.1% of youth aged 10 to 24 years and 2.2% of adults screening positive. Of the 97 patients who screened positive, 96 were non-acute positive screens. Of the full sample, only 1 patient (0.02%) was deemed acute positive, requiring a 1:1 observer and full safety precautions. Conclusion: Universal suicide risk screening was successfully implemented in the NIHCC without incurring a need for additional resources. The intermediate step of a brief suicide safety assessment is a critical part of the workflow, providing guidance for determining appropriate follow-up in a safe and efficient manner that spares limited mental health and hospital resources. Given the increasing suicide rates in the general population, medical venues offer important opportunities for early detection, assessment, and referral.
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U2 - 10.1016/j.jcjq.2020.04.011
DO - 10.1016/j.jcjq.2020.04.011
M3 - Article
C2 - 32473966
AN - SCOPUS:85085514950
SN - 1553-7250
VL - 46
SP - 417
EP - 426
JO - Joint Commission Journal on Quality and Patient Safety
JF - Joint Commission Journal on Quality and Patient Safety
IS - 7
ER -