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Improving Suicide Risk Screening and Detection in the Emergency Department.
- Source :
-
American Journal of Preventive Medicine . Apr2016, Vol. 50 Issue 4, p445-453. 9p. - Publication Year :
- 2016
-
Abstract
- <bold>Introduction: </bold>The Emergency Department Safety Assessment and Follow-up Evaluation Screening Outcome Evaluation examined whether universal suicide risk screening is feasible and effective at improving suicide risk detection in the emergency department (ED).<bold>Methods: </bold>A three-phase interrupted time series design was used: Treatment as Usual (Phase 1), Universal Screening (Phase 2), and Universal Screening + Intervention (Phase 3). Eight EDs from seven states participated from 2009 through 2014. Data collection spanned peak hours and 7 days of the week. Chart reviews established if screening for intentional self-harm ideation/behavior (screening) was documented in the medical record and whether the individual endorsed intentional self-harm ideation/behavior (detection). Patient interviews determined if the documented intentional self-harm was suicidal. In Phase 2, universal suicide risk screening was implemented during routine care. In Phase 3, improvements were made to increase screening rates and fidelity. Chi-square tests and generalized estimating equations were calculated. Data were analyzed in 2014.<bold>Results: </bold>Across the three phases (N=236,791 ED visit records), documented screenings rose from 26% (Phase 1) to 84% (Phase 3) (χ(2) [2, n=236,789]=71,000, p<0.001). Detection rose from 2.9% to 5.7% (χ(2) [2, n=236,789]=902, p<0.001). The majority of detected intentional self-harm was confirmed as recent suicidal ideation or behavior by patient interview.<bold>Conclusions: </bold>Universal suicide risk screening in the ED was feasible and led to a nearly twofold increase in risk detection. If these findings remain true when scaled, the public health impact could be tremendous, because identification of risk is the first and necessary step for preventing suicide.<bold>Trial Registration: </bold>Emergency Department Safety Assessmentand Follow-up Evaluation (ED-SAFE) ClinicalTrials.gov: (NCT01150994). https://clinicaltrials.gov/ct2/show/NCT01150994?term=ED-SAFE&rank=1. [ABSTRACT FROM AUTHOR]
- Subjects :
- *EMERGENCY medical services safety measures
*SUICIDE risk factors
*FOLLOW-up studies (Medicine)
*HEALTH outcome assessment
*FEASIBILITY studies
*TIME series analysis
*SUICIDE prevention
*COMPARATIVE studies
*SELF-injurious behavior
*HOSPITAL emergency services
*RESEARCH methodology
*MEDICAL cooperation
*MEDICAL screening
*RESEARCH
*RESEARCH funding
*RISK assessment
*SUICIDAL behavior
*PILOT projects
*EVALUATION research
*RANDOMIZED controlled trials
*SUICIDAL ideation
*DIAGNOSIS
*PREVENTION
Subjects
Details
- Language :
- English
- ISSN :
- 07493797
- Volume :
- 50
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- American Journal of Preventive Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 113581486
- Full Text :
- https://doi.org/10.1016/j.amepre.2015.09.029