Establish a timeline and pick a realistic date to launch the suicide clinical pathway protocol.
Prepare your staff and patient population:
- Announce plans to staff to incorporate the suicide clinical pathway protocol
- Provide an overview to all staff and initiate training for key staff on the clinical pathway protocol, individual roles, and any related Quality Improvement (QI) processes (see “Train the Staff,” above)
- Consider engaging staff in preparing emails or flyers for patients and families, announcing that you are now screening all patients above age 12 years for suicide risk. In these documents, address some of the common myths about suicide, and reassure families that it’s safe to ask questions about suicide risk
- Consider adding a statement that you are now screening all patients for suicide risk to the paperwork that is provided during office visits: click here for a customizable template
Promote Adherence and Fidelity
Quality Improvement (QI) projects are initiatives that utilize an iterative process with continuous feedback to make process improvements in a short amount of time.
QI projects may be instrumental to success for suicide risk screening and management programs. These projects allow healthcare settings to evaluate effectiveness, as well as identify areas for improvement. QI projects can also fulfill Maintenance of Certification (MOC) Part 4 requirements for pediatricians.
Existing frameworks include:
- Getting to Outcomes® Improving Community-Based Prevention
- Plan-Do-Study-Act Approach
- Consolidated Framework for Implementation Research
- Institute for Healthcare Improvement QI Model
- Extension for Community Healthcare Outcomes (ECHO) with QI
Provide Ongoing Support to Staff
After the program is implemented, unanticipated issues may arise. Maintain open lines of communication between staff and leadership and revise your suicide prevention protocols as needed.
When possible, obtain feedback from staff, patients, and families using brief surveys. Use this feedback to guide future tweaks to the program.
Support your staff:
- Hold a debriefing session after positive screens so all staff involved can discuss what happened and identify opportunities for improvement
- Consider regular, quarterly check-ins to allow staff to talk about the process, provide emotional support, and give frontline staff an opportunity to talk
American Academy of Pediatrics