Virtual Training Role-Plays to Improve Patient Suicide Outcomes in Primary Care Settings

摘要 SIMmersion，与家庭健康研究所(IFH)和教育发展中心合作 (EDC)提议开发一种基于网络的培训产品， 互动培训在预防自杀中的作用 (SPIRIT)，一系列4个模块，用于培训提供者以更有效地管理筛查呈阳性的患者 第一阶段/第二阶段快速通道应用程序中的自杀风险。如果获得资金，该团队将开发风险 第一阶段的评估模块，并利用小组内的事前设计来评估其可行性。二十 将招募执业临床医生使用该模块并完成岗位前知识测试。在第二阶段， 球队将发展S 该产品积极影响患者预后的有效性将通过历史对照试验进行测试。 试验(HCT)招募了五个IFH站点的65名执业临床医生。 安全规划，获得致命手段，并愿意接受转诊模块。 所有提供者都将接受培训并耐心等待 培训结束后将跟踪6个月的结果。此数据集将与6个月的历史数据进行比较 同一提供程序组的数据。这项研究的主要结果将衡量参与者在获得 患者预后的改善与以下方面有关：1)当天C-SSRS筛查率；2)自杀率增加 问题清单；3)当天安全计划率；4)当天C-SSRS生命线/近期比率 完成率；5)当天风险评估率；6)学院内录取率和出席率 为首次就诊的干预后患者提供转介；7)以及较低的 有记录的自杀未遂。最终，该产品的开发和成功测试将提供 美国医疗保健系统是一项新技术，可以增强临床医生的信心和技能，从而更好地管理 被认定为有自杀风险的患者。此外，如果有效，该产品将对 患者结果，这是任何试图培训医疗保健专业人员的培训产品的重要组成部分。 拟议产品的实用性和可扩展性将推动医疗保健系统朝着零死亡的目标迈进 避免自杀符合零自杀的方法。

ABSTRACT SIMmersion, in collaboration with the Institute for Family Health (IFH) and the Educational Development Center (EDC) propose to develop a web-based training product, Suicide Prevention Role-plays for Interactive Training (SPiRIT), a series of 4 modules to train providers to more effectively manage patients who screen positive for risk of suicide in this Phase I/Phase II fast-track application. If funded, the team will develop the Risk Assessment module in Phase I and utilize a within group pre-post design to evaluate its feasibility. Twenty practicing clinicians will be recruited to utilize the module and complete a pre-post knowledge test. In Phase II, the team will develop S The efficacy of the product to positively influence patient outcomes will be tested with a Historically Controlled Trial (HCT) enlisting 65 practicing clinicians across five IFH sites. afety Planning, Access to Lethal Means, and Willingness to Accept a Referral modules. All providers will be trained and patient outcomes will be tracked for 6 months post training. This data set will be compared to 6 months of historical data for the same provider group. Primary outcomes of this study will measure the participants' ability in obtain improved patient outcomes related to: 1) rate of same-day C-SSRS Screening; 2) rate of suicide being added to the problem list; 3) rate of same-day safety planning; 4) rate of same day C-SSRS Lifeline/Recent Completion; 5) rate of same-day Risk Assessment; 6) rate of acceptance and attendance to within-Institute referrals for post intervention patients who are offered the referral at the first visit; 7) and lower rates of documented suicide attempts. Ultimately, the development and successful testing of this product would provide the US health care system a novel technology to scale up a clinician's confidence and skill to better manage patients who identify as at-risk for suicide. Additionally, if effective, this product will have a direct impact on patient outcomes, a vital component to any training product that attempts to train health care professionals. The utility and scalability of the proposed product will move health care systems toward the goal of zero deaths from suicide consistent with the Zero suicide approach.