Journal article
Collaborative to Increase Lethal Means Counseling for Caregivers of Youth With Suicidality
Pediatrics (Evanston), Vol.150(6), p.1
12/01/2022
DOI: 10.1542/peds.2021-055271
PMCID: PMC10578326
PMID: 36321386
Abstract
The number of youth presenting to hospitals with suicidality and/or self-harm has increased substantially in recent years. We implemented a multihospital quality improvement (QI) collaborative from February 1, 2018 to January 31, 2019, aiming for an absolute increase in hospitals' mean rate of caregiver lethal means counseling (LMC) of 10 percentage points (from a baseline mean performance of 68% to 78%) by the end of the collaborative, and to evaluate the effectiveness of the collaborative on LMC, adjusting for secular trends.
This 8 hospital collaborative used a structured process of alternating learning sessions and action periods to improve LMC across hospitals. Electronic medical record documentation of caregiver LMC was evaluated during 3 phases: precollaborative, active QI collaborative, and postcollaborative. We used statistical process control to evaluate changes in LMC monthly. Following collaborative completion, interrupted time series analyses were used to evaluate changes in the level and trend and slope of LMC, adjusting for covariates.
In the study, 4208 children and adolescents were included-1314 (31.2%) precollaborative, 1335 (31.7%) during the active QI collaborative, and 1559 (37.0%) postcollaborative. Statistical process control analyses demonstrated that LMC increased from a hospital-level mean of 68% precollaborative to 75% (February 2018) and then 86% (October 2018) during the collaborative. In interrupted time series analyses, there were no significant differences in LMC during and following the collaborative beyond those expected based on pre-collaborative trends.
LMC increased during the collaborative, but the increase did not exceed expected trends. Interventions developed by participating hospitals may be beneficial to others aiming to improve LMC for caregivers of hospitalized youth with suicidality.
Details
- Title: Subtitle
- Collaborative to Increase Lethal Means Counseling for Caregivers of Youth With Suicidality
- Creators
- JoAnna K Leyenaar - Dartmouth Institute for Health Policy and Clinical PracticeAnagha Tolpadi - The University of Texas at AustinLayla Parast - The University of Texas at AustinMegan Esporas - Vynamic, Durham, NC.Maria T Britto - Cincinnati Children's Hospital Medical CenterCourtney GidengilKaren M Wilson - University of RochesterNaomi S Bardach - University of California, San FranciscoWilliam T Basco - Medical University of South CarolinaMark S Brittan - Children's Hospital ColoradoDerek J Williams - Monroe Carell Jr. Children's HospitalKelly E Wood - University of IowaSteven Yung - Icahn School of Medicine at Mount SinaiErin Dawley - Medical University of South CarolinaAudrey Elliott - Children's Hospital ColoradoKirstin A Manges - Roy J. and Lucille A. Carver College of MedicineGregory Plemmons - Monroe Carell Jr. Children's HospitalTimothy Rice - Icahn School of Medicine at Mount SinaiBrandy Wiener - Cincinnati Children's Hospital Medical CenterRita Mangione-Smith - Kaiser Permanente Washington Health Research Institute
- Resource Type
- Journal article
- Publication Details
- Pediatrics (Evanston), Vol.150(6), p.1
- DOI
- 10.1542/peds.2021-055271
- PMID
- 36321386
- PMCID
- PMC10578326
- NLM abbreviation
- Pediatrics
- ISSN
- 0031-4005
- eISSN
- 1098-4275
- Grant note
- U18 HS025291 / AHRQ HHS
- Language
- English
- Date published
- 12/01/2022
- Academic Unit
- Stead Family Department of Pediatrics; Hospital Medicine
- Record Identifier
- 9984353826302771
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