Skip to main content
Top
Published in: Psychiatric Quarterly 4/2015

01-12-2015 | Original Paper

Suicide Attempts After Emergency Room Visits: The Effect of Patient Safety Goals

Author: John Robst

Published in: Psychiatric Quarterly | Issue 4/2015

Login to get access

Abstract

In 2007 the Joint Commission National Patient Safety Goals included a requirement addressing risks associated with patient suicidality. The rational for this requirement was that suicide has been the most frequently reported sentinel event since the inception of the Sentinel Event Policy in 1996. The Patient Safety Goals on suicide required hospitals implement actions to assess suicide risk, meet client’s immediate safety needs and provide information such as a crisis hotline to individuals and family members for crisis situations. This study performed a secondary data analysis to assess the effect of the 2007 Joint Commission Patient Safety Goals on suicide attempts among patients following treatment at hospital emergency rooms among individuals enrolled in the Florida Medicaid program. A difference-in-difference approach compared changes in rates of suicide attempts for individuals with a primary mental health diagnosis and individuals with a physical health diagnosis after emergency room treatment. In the 6 months following treatment, suicide rates declined after implementation of the goals among patients treated for a primary mental health diagnosis, and increased among patients with a poisoning diagnosis, compared to individuals with a physical health diagnosis. The goals were associated with a reduction in suicide attempts after emergency room treatment.
Footnotes
1
An ER visit due to a suicide attempt was not included as a distinct observation for this analysis because it is well known that a suicide attempt is a clear risk factor for future suicide risk and merits psychiatric intervention.
 
Literature
1.
go back to reference Joint Commission on Accreditation of Healthcare Organization: Medical errors, sentinel events, and accreditation. A report to the to the Association of Anesthesia Program directors: Oct 28, 2000. Joint Commission on Accreditation of Healthcare Organization: Medical errors, sentinel events, and accreditation. A report to the to the Association of Anesthesia Program directors: Oct 28, 2000.
2.
go back to reference Kohn LT, Corrigan JM, Donaldson MS: To err is human: Building a safer health system. Washington, National Academy Press, 1999. Kohn LT, Corrigan JM, Donaldson MS: To err is human: Building a safer health system. Washington, National Academy Press, 1999.
5.
go back to reference Ronquillo L, Minassian A, Vilke GM, Wilson MP: Literature-based recommendations for suicide assessment in the emergency department: A review. Journal of Emergency Medicine 43:836–842, 2012.CrossRefPubMed Ronquillo L, Minassian A, Vilke GM, Wilson MP: Literature-based recommendations for suicide assessment in the emergency department: A review. Journal of Emergency Medicine 43:836–842, 2012.CrossRefPubMed
6.
go back to reference Yaseen ZS, Gilmer E, Modi J, Cohen LJ, Galynker II: Emergency room validation of the Revised Suicide Trigger Scale (STS-3): A measure of a hypothesized suicide trigger state. PLOS One 7:e45157, 2012.PubMedCentralCrossRefPubMed Yaseen ZS, Gilmer E, Modi J, Cohen LJ, Galynker II: Emergency room validation of the Revised Suicide Trigger Scale (STS-3): A measure of a hypothesized suicide trigger state. PLOS One 7:e45157, 2012.PubMedCentralCrossRefPubMed
7.
go back to reference Claassen CA, Larkin GL: Occult suicidality in an emergency department population. British Journal of Psychiatry 186:352–353, 2005.CrossRefPubMed Claassen CA, Larkin GL: Occult suicidality in an emergency department population. British Journal of Psychiatry 186:352–353, 2005.CrossRefPubMed
8.
go back to reference Gairin I, House A, Owens D: Attendance at the accident and emergency department in the year before suicide: Retrospective study. British Journal of Psychiatry 183:28–33, 2003.CrossRefPubMed Gairin I, House A, Owens D: Attendance at the accident and emergency department in the year before suicide: Retrospective study. British Journal of Psychiatry 183:28–33, 2003.CrossRefPubMed
9.
go back to reference Michel K, et al.: Contacts of suicide attempters with GPs prior to the event: A comparison between Stockholm and Bern. Acta Psychiatrica Scandinavica 95:94–99, 1997.CrossRefPubMed Michel K, et al.: Contacts of suicide attempters with GPs prior to the event: A comparison between Stockholm and Bern. Acta Psychiatrica Scandinavica 95:94–99, 1997.CrossRefPubMed
10.
go back to reference Pirkis J, Burgess P: Suicide and recency of health care contacts: A systematic review. British Journal of Psychiatry 173: 462–474, 1998.CrossRefPubMed Pirkis J, Burgess P: Suicide and recency of health care contacts: A systematic review. British Journal of Psychiatry 173: 462–474, 1998.CrossRefPubMed
11.
go back to reference Gunnarsdottir OS, Rafnsson V: Non-causative discharge diagnosis from the emergency department and risk of suicide. Journal of Emergency Medicine 38:286–292, 2010a.CrossRefPubMed Gunnarsdottir OS, Rafnsson V: Non-causative discharge diagnosis from the emergency department and risk of suicide. Journal of Emergency Medicine 38:286–292, 2010a.CrossRefPubMed
12.
go back to reference Gunnarsdottir OS, Rafnsson V: Risk of suicide and fatal poisoning after discharge from the emergency department: A nested case-control study. Emergency Medicine Journal 27:93–96, 2010b.CrossRefPubMed Gunnarsdottir OS, Rafnsson V: Risk of suicide and fatal poisoning after discharge from the emergency department: A nested case-control study. Emergency Medicine Journal 27:93–96, 2010b.CrossRefPubMed
13.
go back to reference Rafnsson V, Gunnarsdottir OS: All-cause mortality and suicide within 8 days after emergency department discharge. Scandinavian Journal of Public Health 41:832–838, 2013.CrossRefPubMed Rafnsson V, Gunnarsdottir OS: All-cause mortality and suicide within 8 days after emergency department discharge. Scandinavian Journal of Public Health 41:832–838, 2013.CrossRefPubMed
14.
go back to reference Anderson R: Behavioral Model of Families’ Use of Health Services. Research Series No. 25. Chicago, Center for Health Administration Studies, University of Chicago, 1968. Anderson R: Behavioral Model of Families’ Use of Health Services. Research Series No. 25. Chicago, Center for Health Administration Studies, University of Chicago, 1968.
15.
go back to reference Anderson R, Davidson P, Ganz P: Symbiotic relationships of quality of life: Health services research, and other health research. Quality of Life Research 3: 365–371, 1994.CrossRef Anderson R, Davidson P, Ganz P: Symbiotic relationships of quality of life: Health services research, and other health research. Quality of Life Research 3: 365–371, 1994.CrossRef
16.
go back to reference McGaha A, Stiles P, Petrila J: Emergency involuntary psychiatric examinations in Florida. Psychiatric Services 53:1171–1172, 2002.CrossRefPubMed McGaha A, Stiles P, Petrila J: Emergency involuntary psychiatric examinations in Florida. Psychiatric Services 53:1171–1172, 2002.CrossRefPubMed
17.
go back to reference Roggenbaum S, Christy A, LeBlanc A, McCranie M, Murrin MR, Li Y: The relationship of suicide death to baker act examination, client characteristics and service use patterns (Agency for Health Care Administration (AHCA) Series, 220-116). Tampa, University of South Florida, Louis de la Parte Florida Mental Health Institute, 2008. Roggenbaum S, Christy A, LeBlanc A, McCranie M, Murrin MR, Li Y: The relationship of suicide death to baker act examination, client characteristics and service use patterns (Agency for Health Care Administration (AHCA) Series, 220-116). Tampa, University of South Florida, Louis de la Parte Florida Mental Health Institute, 2008.
18.
go back to reference Choudhry NK, Fletcher RH, Soumerai SB: Systematic review: The relationship between clinical experience and quality of health care. Annals of Internal Medicine 142: 260–273, 2005.CrossRefPubMed Choudhry NK, Fletcher RH, Soumerai SB: Systematic review: The relationship between clinical experience and quality of health care. Annals of Internal Medicine 142: 260–273, 2005.CrossRefPubMed
19.
go back to reference Lin HC, Lee HC, Kuo NW, Chu CH: Hospital characteristics associated with post-discharge suicide of severely depressed patients. Journal of Affective Disorders 110: 215–221, 2008.CrossRefPubMed Lin HC, Lee HC, Kuo NW, Chu CH: Hospital characteristics associated with post-discharge suicide of severely depressed patients. Journal of Affective Disorders 110: 215–221, 2008.CrossRefPubMed
Metadata
Title
Suicide Attempts After Emergency Room Visits: The Effect of Patient Safety Goals
Author
John Robst
Publication date
01-12-2015
Publisher
Springer US
Published in
Psychiatric Quarterly / Issue 4/2015
Print ISSN: 0033-2720
Electronic ISSN: 1573-6709
DOI
https://doi.org/10.1007/s11126-015-9345-7

Other articles of this Issue 4/2015

Psychiatric Quarterly 4/2015 Go to the issue