Improving Identification of Static and Dynamic Risk Factors for Suicide in Adolescent Outpatient Mental Health: A Quality Improvement Project

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Buresh, Paige
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Purpose: The purpose of this project was to increase screening for risk factors of suicide, utilizing a standardized tool as part of the clinician’s initial assessment process for patients aged 12-18 undergoing outpatient mental health treatment.|Background: Suicide is the second leading cause of death amongst adolescents in the United States. Eighty-five percent of adolescents who died by suicide have visited an outpatient psychiatric provider in the previous year, 54% within three months, and 30-35.1% within 30 days (De Leo et al., 2013; Lanier et al., 2021; Schaffer et al., 2016). The Joint Commission (2019) and Healthy People 2030 (2020) have called upon healthcare providers to reduce the rate of suicide in adolescents by conducting suicide risk assessments during healthcare visits for patients aged 12 and older with a standardized screening tool.|Sample/Setting: The study included 37 patient charts. Charts were selected by convenience sampling on initial intake assessments for adolescents aged 12 to 18 at a psychiatric outpatient clinic in a Midwest urban area.|Methods: A retrospective chart review of 15 charts over a 6-week period tracked the completion of suicide risk factor screening for adolescents, based on TASR-A criteria. An educational session was conducted on the selected tool, adolescent suicide risk factors, and the quality improvement project. Then the tool was implemented for 6-weeks on initial intakes for adolescent patients. Afterward, a prospective chart review was conducted on 22 charts. Lastly, interviews were completed to determine barriers and usability of the TASR-A.|Results: Overall, a 55% improvement in suicide risk screenings and 86% increased risk level detection. The interviews revealed that the tool was easy to utilize and helped identify risk factors specific to adolescents.|Conclusion: A standardized tool, such as TASR-A, helps assess suicide risk level in adolescents and aids in the documentation of risk level.
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