Impact of Telehealth on Emergency Department Management of Suicide Risk

远程医疗对急诊科自杀风险管理的影响

• 批准号: 10383736
• 负责人: Stephanie Doupnik
• 金额: $ 56.93万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-15 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10383736
• 关键词: Accident and Emergency department; Address; Adopted; Adult; Affect; Caring; Cause of Death; Cessation of life; Characteristics; Child; Code; Communities; Contracts; Data; Dissemination and Implementation; Electronic Health Record; Emergency Care; Emergency Department evaluation; Emergency Department patient; Emergency department visit; Evaluation; Evidence based practice; Feeling suicidal; Health Personnel; Health Service Area; Health Services; Health Services Accessibility; Health system; Healthcare; Hospitals; Hour; Improve Access; Individual; Intervention; Interview; Link; Location; Mediating; Medicaid; Mental Health; Mental Health Services; National Institute of Mental Health; Outcome; Patient-Focused Outcomes; Patients; Persons; Provider; Psychiatrist; Public Health; Reporting; Research; Resource Allocation; Resources; Risk Assessment; Role; Rural Hospitals; Safety; Sampling; Services; Site; Social Workers; Source; Specialist; Strategic Planning; Structure; Suicide; Suicide attempt; Suicide prevention; Surveys; Teaching Hospitals; Technology; Telemental; Testing; Treatment outcome; Vulnerable Populations; age group; base; evidence base; follow-up; future implementation; high risk; high risk population; hospital services; implementation barriers; implementation efforts; implementation facilitators; improved; individual patient; interest; parity; programs; resource guides; rural area; screening; suicidal morbidity; suicidal risk; suicide rate; symposium; telehealth; telehealthcare

Project Summary/Abstract Children and adults in the US are increasingly seeking treatment in Emergency Departments (EDs) for suicide ideation (SI) and suicide attempt (SA), and suicide is a leading cause of death across age groups. The ED setting has become a critical point of intervention to prevent suicide in the US. In spite of this demonstrated need, most EDs lack resources to address suicide risk, and there is an urgent need to identify strategies to improve evidence-based care for this high-risk and vulnerable population. There is increasing interest in the use of technology to address provider shortages and related gaps in care. Tele-mental health, hereafter “telehealth,” relies on technologies including video- and audio-conferencing with remote clinicians and use of shared electronic health records to improve access to mental health specialists. To date, little is known about how EDs use telehealth, and specifically how telehealth services integrate evidence-based practices (EBPs) to evaluate and manage patients at high risk of suicide. Further, there is little information to dissemination and implementation efforts for telehealth. The objectives of this project are to gain a comprehensive picture of telehealth use among children and adults visiting EDs for SI/SA, including whether it increases access to treatment and improves treatment outcomes, and to gather information relevant to future implementation efforts. Using a national survey, the study team will capture detailed data on suicide prevention practices in EDs who do and do not use telehealth. Specifically, we will survey a national sample of 600 EDs and examine which hospital and service area characteristics are associated with (a) presence of telehealth services and (b) telehealth service characteristics (clinician credentials, hours of availability, technologies, billing, and clinician contracts).

项目总结/摘要 在美国，越来越多的儿童和成人因自杀意念（SI）和自杀企图（SA）而在急诊科（ED）寻求治疗，自杀是各年龄组死亡的主要原因。在美国，艾德环境已成为预防自杀干预的关键点。尽管这一需求得到了证实，但大多数ED缺乏解决自杀风险的资源，迫切需要确定战略，以改善对这一高风险和弱势群体的循证护理。人们越来越关注利用技术来解决提供者短缺和相关的护理差距。远程精神保健，以下简称“远程保健”，依赖于包括与远程临床医生举行视频和音频会议以及使用共享电子健康记录等技术，以改善获得精神保健专家服务的机会。迄今为止，人们对ED如何使用远程医疗知之甚少，特别是远程医疗服务如何整合循证实践（EBP）来评估和管理自杀高风险患者。此外，关于远程保健的传播和实施工作的信息很少。该项目的目标是全面了解因SI/SA而访问急诊室的儿童和成人使用远程保健的情况，包括它是否增加了获得治疗的机会并改善了治疗结果，并收集与未来实施工作有关的信息。通过一项全国性的调查，研究小组将收集有关使用和不使用远程医疗的ED自杀预防实践的详细数据。具体来说，我们将调查全国样本的600个ED和检查哪些医院和服务区的特点与（a）存在的远程医疗服务和（B）远程医疗服务的特点（临床医生的凭据，可用时间，技术，计费和临床医生合同）。