Improving Youth Suicide Risk Screening and Assessment in a Pediatric Hospital Setting by Using The Joint Commission...

Area of Science:

• Pediatric Emergency Medicine
• Behavioral Health Services
• Healthcare Quality Improvement

Background:

• Hospitals accredited by The Joint Commission (TJC) must implement validated suicide risk screening and assessment for behavioral health patients.
• This requirement necessitates a standardized approach to identify and manage suicide risk effectively.

Purpose of the Study:

• Implement a TJC-compliant suicide risk screening and assessment process in a pediatric emergency department (ED) and outpatient behavioral health clinic.
• Characterize the population regarding suicide risk factors.
• Evaluate the impact of the new process on ED length of stay (LOS).

Main Methods:

• Developed and implemented a workflow using the Columbia Suicide Severity Rating Scale.
• Conducted monthly compliance reviews for screening and assessment.
• Used descriptive statistics and multivariable regression to analyze population characteristics and factors associated with suicide risk and ED discharge.
• Compared ED LOS before and after process implementation.

Main Results:

• Achieved 83% screening compliance in the ED and 65% in outpatient clinics.
• Increased standardized assessment compliance in the ED from 0% to 88%.
• Identified that 72% of ED behavioral health patients and 18% of outpatient behavioral health patients screened positive for suicide risk.
• Found no increase in ED LOS after implementation.
• Observed that most patients screening at risk were discharged after assessment.

Conclusions:

• Successfully implemented a TJC-compliant suicide risk screening and assessment process for behavioral health patients.
• The implementation did not lead to an increase in ED LOS.
• This process is effective in identifying at-risk patients within a pediatric healthcare setting.