Clinical Research Coordinator II St. Luke's Health System Meridian, Idaho, United States
Body of Abstract: Introduction. In 2020, Idaho’s age-adjusted suicide rate was over 70% higher than the US national average . St . Luke’s Health System (SLHS), a large, regional, not-for-profit health system in Idaho, conducts universal suicide screening using the Columbia Suicide Severity Rating Scale 6-Item Screener (C-SSRS) in Emergency Departments (EDs), and from 2019 – 2023, conducted universal suicide screening in primary care (PC) clinics. Patients who endorse suicidal ideation on the C-SSRS receive a clinical risk assessment, and a safety planning intervention.
Study Aim. To characterize physician and clinician beliefs, attitudes, and practices related to standard suicide care.
Methods. We conducted a mixed methods analysis of quantitative and qualitative data from a cross-sectional survey of physicians and clinicians at SLHS. All participants responded to 6 questions, and physicians, APPs, and social workers responded to 14 additional in-depth questions about suicide assessment and safety planning workflows and provided open-ended feedback. Three reviewers conducted inductive content analysis to identify higher- and lower-order themes in the free text data. Quantitative data were summarized using descriptive statistics.
Results. A total of 237 clinicians (44 physicians, 20 advanced practice providers (APPs), 21 social workers, 90 nurses, 38 medical assistants, and 24 other clinicians) from 9 EDs and 36 primary care clinics completed the survey. Overall, 43.0% of participants agreed strongly and 36.3% of participants agreed somewhat that SLHS provides high quality suicide prevention care for patients who screen positive for suicidal ideation or behavior. Among physicians, APPs, and social workers, 31.7% agreed strongly and 56.1% agreed somewhat that the Safety Planning Intervention is an effective way to help keep suicidal patients safe. A total of 35.7% reported safety planning was going very well where they worked, and 47.5% reported it was going somewhat well. Additionally, 32.3% of those providers responded that they believed suicide prevention overall was going very well where they work at St. Luke's, and 53.6% believed it was going somewhat well. Key themes emerging from the qualitative analysis were related to availability of staff (social work, behavioral health, personal safety attendants), wait times for care, workflow disruption and adherence, primary care provider time, the SPARC clinical trial, and concerns about negative patient experiences related to ligature measures, patient autonomy, privacy, and language barriers. We will present additional detail on each theme and summarize key recommendations for suicide prevention care in primary care and ED settings.
Conclusions. Physicians and clinicians value delivery of high-quality suicide care for their patients, and face several important barriers – some of which can be addressed – in delivering consistently high quality suicide prevention care to their patients.
Learning Objectives:
Discuss specific barriers physicians and other clinicians face implementing suicide prevention workflows
Generate ideas for improving suicide prevention workflows and increasing adherence to standardized suicide care protocols in healthcare settings
Describe feedback from physicians and clinicians related to the safety planning intervention
