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Analysis of Hospitals Switching From a "Danger to Self" Question to Universal Columbia-Suicide Severity Rating Scale Screening: Impact on Screenings, Identification of Suicide Risk, and Documented Psychiatric Care.
Dillon, Ellis C; Deng, Sien; Li, Martina; Huang, Qiwen; de Vera, Ernell; Pesa, Jacqueline; Nguyen, Tam; Kiger, Anna; Becker, Daniel F; Azar, Kristen.
Afiliação
  • Dillon EC; Center on Aging University of Connecticut Health Center Farmington Connecticut USA.
  • Deng S; Sutter Health Center for Health Systems Research and Palo Alto Medical Foundation Research Institute Sutter Health Palo Alto California USA.
  • Li M; Sutter Health Center for Health Systems Research and Palo Alto Medical Foundation Research Institute Sutter Health Palo Alto California USA.
  • Huang Q; Sutter Health Center for Health Systems Research and Palo Alto Medical Foundation Research Institute Sutter Health Palo Alto California USA.
  • de Vera E; Mental Health & Addiction Care Sutter Health Sacramento California USA.
  • Pesa J; US Real World Value & Evidence Janssen Scientific Affairs Horsham Pennsylvania USA.
  • Nguyen T; Mental Health & Addiction Care Sutter Health Sacramento California USA.
  • Kiger A; Office of the System Chief Nurse Officer Sutter Health Sacramento California USA.
  • Becker DF; Department of Psychiatry and Behavioral Sciences University of California San Francisco San Francisco California USA.
  • Azar K; Institute for Advancing Health Equity Sutter Health Walnut Creek California USA.
Psychiatr Res Clin Pract ; 6(2): 51-60, 2024.
Article em En | MEDLINE | ID: mdl-38854873
ABSTRACT

Objective:

Sutter Health launched system-wide general population standardized suicide screening with the Columbia-Suicide Severity Rating Scale (C-SSRS) screen (triage) version in 23 hospitals in 2019, replacing a one-question "danger to self" (DTS) assessment. This study analyzed the impact of C-SSRS implementation on screening rates, positive screenings, and documented psychiatric care within 90 days for all patients and a subgroup diagnosed with Major Depressive Disorder (MDD).

Methods:

Adults seen at hospitals in the pre-period (July 1, 2017-June 30, 2019) and post-period (July 1, 2019-December 31, 2020) were identified using electronic health records. Outcomes were compared using chi-square statistics and interrupted time series (ITS) models.

Results:

Pre-period, 92.8% (740,984/798,653) of patients were screened by DTS versus 84.6% (504,015/595,915) by C-SSRS in the post-period. Positive screening rates were 1.5% pre-period and 2.2% post-period, and 9.2% pre-period versus 10.8% post-period for those with MDD. Among individuals with positive screenings, 64.0% (pre-period) had documented follow-up psychiatric care versus 52.5% post-period and 66.4% of those with moderate or high-risk. Among all patients seen there was an overall increase in documentation of psychiatric care within 90 days (0.87% pre- to 0.96% post-period). ITS models revealed a 9.6% decline in screening, 1.3% increase in positive screenings, and 12.9% decline in documented psychiatric care following C-SSRS implementation (all p < 0.01).

Conclusions:

Following implementation, there was meaningful increase in suicide risk identification, and an increase in the proportion of patients with documented psychiatric care. Observed relative declines in screening warrant future research examining opportunities and barriers to general population C-SSRS use.

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article