Open AccessImproving Youth Suicide Risk Screening and Assessment in a Pediatric Hospital Setting by Using The Joint Commission Guidelines
Author(s) -
Finza Latif,
Shilpa J. Patel,
Gia M. Badolato,
Kenneth McKinley,
Clarissa Chan-Salcedo,
Reginald Bannerman,
Theresa Ryan Schultz,
Jacqueline Newton,
Meghan Marie Schott,
Colby M Tyson,
Theresa Wavra,
Adelaide S. Robb
Publication year - 2020
Publication title -
hospital pediatrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 20
eISSN - 2154-1663
pISSN - 2154-1671
DOI - 10.1542/hpeds.2020-0039
Subject(s) - medicine , emergency department , risk assessment , population , outpatient clinic , occupational safety and health , poison control , suicide prevention , health care , medical emergency , injury prevention , family medicine , emergency medicine , psychiatry , environmental health , computer security , pathology , computer science , economics , economic growth
OBJECTIVES: Hospitals accredited by The Joint Commission (TJC) are now required to use a validated screening tool and a standardized method for assessment of suicide risk in all behavioral health patients. Our aims for this study were (1) to implement a TJC-compliant process of suicide risk screening and assessment in the pediatric emergency department (ED) and outpatient behavioral health clinic in a large tertiary care children’s hospital, (2) to describe characteristics of this population related to suicide risk, and (3) to report the impact of this new process on ED length of stay (LOS). METHODS: A workflow using the Columbia Suicide Severity Rating Scale was developed and implemented. Monthly reviews of compliance with screening and assessment were conducted. Descriptive statistics were used to define the study population, and multivariable regression was used to model factors associated with high suicide risk and discharge from the ED. ED LOS of behavioral health patients was compared before and after implementation. RESULTS: Average compliance rates for screening was 83% in the ED and 65% in the outpatient clinics. Compliance with standardized assessments in the ED went from 0% before implementation to 88% after implementation. The analysis revealed that 72% of behavioral health patients in the ED and 18% of patients in behavioral health outpatient clinics had a positive suicide risk. ED LOS did not increase. The majority of patients screening at risk was discharged from the hospital after assessment. CONCLUSIONS: A TJC-compliant process for suicide risk screening and assessment was implemented in the ED and outpatient behavioral health clinic for behavioral health patients without increasing ED LOS.