Emergency Department Safety Assessment and Follow-up Evaluation 2

Completed · Not applicable

Conditions studied: Suicide

In brief

Many patients at risk for suicide are discharged from the ED with little or no intervention. Evidence-based suicide prevention interventions, like universal screening and safety planning should be adopted in clinical practice to help prevent suicidal behavior. This study will test the long-term sustainability of the nurse administered universal screening implemented in the original ED-SAFE study. Also, the investigators will test the impact of a new personalized Safety Planning Intervention guided by Lean has on suicide composite outcomes. The ED-SAFE-2 will use a stepped wedge design where the original eight ED-SAFE sites will collect quantitative and qualitative data during the three phases: Baseline, Implementation, and Maintenance. Using this data, the ED-SAFE-2 will examine both within and between site differences for existing screening practices and new care processes, including safety planning. Most of the data collection on outcomes will be done by retrospective chart review. A Lean Implementation Strategy will be used to ensure that adoption of improved care processes are fully supported vertically and horizontally within the organization, infrastructure is built that supports the efforts, and that the protocols fit naturally within roles, responsibilities, and clinical flow. Consistent with the RFA's emphasis, the intervention target will be the clinician's behavior, including, at minimum, screening and safety planning. All emergency mental health and nursing personnel at the sites will be trained on safety planning, and Lean will be used to help ensure the safety planning is being implemented properly and consistently. The mechanisms of action of the combination of the safety planning training and Lean will be studied, allowing the team to establish both the effect the intervention has on the intervention target but also on the mechanisms of action comprised of departmental culture change and infrastructure support.

Key facts

Study ID

NCT02453243

Run by

University of Massachusetts, Worcester

People needed

14250

Starts

2014-01-01

Expected to finish

2018-10-01

Last updated by the study team

2020-08-07

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• ED patients >18 years old
• Seen in ED triage

You may not qualify if…

• patients <18 years old
• not seen in ED triage
• Adults unable to consent
• Prisoners

Where it is running

• Maricopa Medical Center — Phoenix, Arizona, United States
• University of Arkansas Medical Center — Little Rock, Arkansas, United States
• University of Colorado Hospital — Aurora, Colorado, United States
• Beth Israel Deaconess Medical Center — Boston, Massachusetts, United States
• Marlborough Hospital — Marlborough, Massachusetts, United States
• University of Nebraska Medical Center — Omaha, Nebraska, United States
• Ohio State Univeristy Medical Center — Columbus, Ohio, United States
• Memorial Hospital of Rhode Island — Pawtucket, Rhode Island, United States

Full record on ClinicalTrials.gov

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