Assessing Suicide Risk in a Pediatric Outpatient Behavioral Health System: A Quality Improvement Report.
Assessing Suicide Risk in a Pediatric Outpatient Behavioral Health System: A Quality Improvement Report.
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DOI：
10.1097/pq9.0000000000000571
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发表时间：
2022-05
影响因子：
1.1
通讯作者：
中科院分区：
文献类型：
--
作者：
标准化的自杀风险评估可以提高对有自杀风险的个人的发现。我们在一家独立儿童医院附属的门诊行为健康实践系统中开展了质量改进活动，对新患者实施标准化自杀风险评估。临床医生接受了自杀风险评估方面的教育，并接受了使用循证自杀风险评估工具——哥伦比亚自杀严重程度评定量表（C-SSRS）的培训。我们标准化了工作流程，并将 C-SSRS 集成到电子健康记录中，并具有通过问题列表在护理团队之间传达高风险实例的功能。我们分析了 C-SSRS 的反应和对标准化流程的遵守情况，并比较了实施前后问题清单上有自杀相关项目的患者百分比。我们通过一项调查评估了临床医生的知识。所有具有自杀风险的患者均在常规护理的情况下接受治疗以降低自杀风险。对于实施后（2016 年 11 月至 2018 年 12 月）发生的 3,972 名新患者就诊，标准化流程的平均每月遵守率为 97.7%。非特异性主动自杀念头的平均每月发生率为 16%，中止的自杀企图为 2%，实际自杀企图为 3%。问题清单上记录的自杀相关项目在实施后的平均每月发生率为 5.66%，而实施前 1 年为 1.47%。临床医生对自杀风险因素和评估的了解在统计上显着增加。自杀风险评估流程的标准化改进了儿科门诊行为健康环境中自杀风险的检测和记录。
Standardized suicide risk assessment improves the detection of individuals at risk of suicide. We conducted a quality improvement initiative in a system of outpatient behavioral health practices affiliated with a free-standing children’s hospital to implement standardized suicide risk assessment for new patients. Clinicians received education in suicide risk assessment and were trained to use an evidence-based suicide risk assessment tool, the Columbia Suicide Severity Rating Scale (C-SSRS). We standardized workflow processes and integrated the C-SSRS in the electronic health record with a feature to communicate instances of elevated risk across care teams through a problem list. We analyzed C-SSRS responses and adherence to standardized processes and compared the percentage of patients with a suicide-related item on the problem list before and after implementation. We assessed clinician knowledge through a survey. All patients with identified suicide risk received treatment to reduce their risk of suicide in the context of usual care. For 3,972 new patient visits occurring postimplementation (November 2016–December 2018), the average monthly adherence to the standardized process was 97.7%. The mean monthly incidence of nonspecific active suicidal thoughts was 16%, aborted suicide attempts were 2%, and actual suicide attempts were 3%. The mean monthly incidence of a suicide-related item documented on the problem list was 5.66% in the postimplementation period compared with 1.47% in the 1-year preimplementation. Clinicians demonstrated statistically significant increases in knowledge about suicide risk factors and assessment. Standardization of suicide risk assessment processes improved detection and documentation of suicide risk in a pediatric outpatient behavioral health setting.
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DOI：
10.1016/j.jpeds.2021.10.031
发表时间：
2022-03
期刊：
The Journal of pediatrics
影响因子：
--
作者：
Crandal BR;Aguinaldo LD;Carter C;Billman GF;Sanderson K;Kuelbs C
通讯作者：
Kuelbs C
DOI：
10.1176/appi.ps.201200587
发表时间：
2013-12-01
期刊：
Psychiatric services (Washington, D.C.)
影响因子：
--
作者：
Simon GE;Rutter CM;Peterson D;Oliver M;Whiteside U;Operskalski B;Ludman EJ
通讯作者：
Ludman EJ
影响因子：
--
作者：
Latif, Finza;Patel, Shilpa;Robb, Adelaide S
通讯作者：
Robb, Adelaide S
影响因子：
5.5
作者：
Boudreaux, Edwin D.;Camargo, Carlos A., Jr.;Miller, Ivan W.
通讯作者：
Miller, Ivan W.
影响因子：
5.4
作者：
Ogrinc, Greg;Davies, Louise;Stevens, David
通讯作者：
Stevens, David