Evaluating the Prevalence of Four Recommended Practices for Suicide Prevention Following Hospital Discharge

IF 2.3 Q2 HEALTH CARE SCIENCES & SERVICES Joint Commission journal on quality and patient safety Pub Date : 2024-06-01 DOI:10.1016/j.jcjq.2024.02.007
Salome O. Chitavi PhD (is Research Scientist II, Department of Research, Division of Healthcare Quality Evaluation and Improvement, The Joint Commission, Oakbrook Terrace, Illinois.), Jamie Patrianakos PhD (is Research Scientist I, Department of Research, Division of Healthcare Quality Evaluation and Improvement. The Joint Commission.), Scott C. Williams PsyD (is Director, Department of Research, Division of Healthcare Quality Evaluation and Improvement, The Joint Commission.), Stephen P. Schmaltz PhD, MPH, MS (is Senior Biostatistician, Department of Research, Division of Healthcare Quality Evaluation and Improvement, The Joint Commission.), Brian K. Ahmedani PhD, LMSW (is Director, Center for Health Policy and Health Services Research, and Director of Research, Behavioral Health Services, Henry Ford Health, Detroit.), Kimberly Roaten PhD, ABPP (is Professor, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas.), Edwin D. Boudreaux PhD (is Professor, Departments of Emergency Medicine, Psychiatry, and Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School.), Gregory K. Brown PhD (is Associate Professor of Clinical Psychology in Psychiatry, Perelman School of Medicine, University of Pennyslvania. Please address correspondence to Salome Chitavi)
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Abstract

Background

The Joint Commission's National Patient Safety Goal (NPSG) for suicide prevention (NPSG.15.01.01) requires that accredited hospitals maintain policies/procedures for follow-up care at discharge for patients identified as at risk for suicide. The proportion of hospitals meeting these requirements through use of recommended discharge practices is unknown.

Methods

This cross-sectional observational study explored the prevalence of suicide prevention activities among Joint Commission–accredited hospitals. A questionnaire was sent to 1,148 accredited hospitals. The authors calculated the percentage of hospitals reporting implementation of four recommended discharge practices for suicide prevention.

Results

Of 1,148 hospitals, 346 (30.1%) responded. The majority (n = 212 [61.3%]) of hospitals had implemented formal safety planning, but few of those (n = 41 [19.3%]) included all key components of safety planning. Approximately a third of hospitals provided a warm handoff to outpatient care (n = 128 [37.0%)] or made follow-up contact with patients (n = 105 [30.3%]), and approximately a quarter (n = 97 [28.0%]) developed a plan for lethal means safety. Very few (n = 14 [4.0%]) hospitals met full criteria for implementing recommended suicide prevention activities at time of discharge.

Conclusion

The study revealed a significant gap in implementation of recommended practices related to prevention of suicide postdischarge. Additional research is needed to identify factors contributing to this implementation gap.

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评估出院后预防自杀的四项建议措施的普遍性。
背景:联合委员会关于预防自杀的国家患者安全目标(NPSG)(NPSG.15.01.01)要求获得认证的医院制定相关政策/程序,对被确认有自杀风险的患者进行出院后续护理。目前尚不清楚通过使用推荐的出院措施来达到这些要求的医院比例:这项横断面观察研究探讨了获得联合委员会认证的医院中开展自杀预防活动的普遍程度。研究人员向 1148 家通过认证的医院发放了调查问卷。作者计算了报告实施了四种预防自杀建议出院措施的医院的百分比:在 1,148 家医院中,有 346 家(30.1%)做出了回复。大多数医院(n = 212 [61.3%])都实施了正式的安全规划,但其中只有少数医院(n = 41 [19.3%])包含了安全规划的所有关键要素。约三分之一的医院为门诊病人提供了温馨的交接服务(n = 128 [37.0%]),或与病人进行了后续联系(n = 105 [30.3%]),约四分之一的医院(n = 97 [28.0%])制定了致命手段安全计划。只有极少数医院(n = 14 [4.0%])完全符合在患者出院时开展建议的预防自杀活动的标准:研究显示,在实施与预防出院后自杀相关的建议措施方面存在很大差距。需要开展更多的研究来确定造成这种实施差距的因素。
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来源期刊
CiteScore
3.80
自引率
4.30%
发文量
116
审稿时长
49 days
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Table of Contents Editorial Board The Joint Commission Journal on Quality and Patient Safety 50th Anniversary Article Collections: 50 Most Cited Table of Contents Editorial Board
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