Keywords: Suicide | Prevention
Presentation Type: Symposium
No study to date has examined the effectiveness of integrating clinical decision support tools, like electronic health record (EHR) alerts, into clinical care of youth at risk for suicide.We developed an EHR alert designed to increase to clinicians’ use of safety planning with youth at risk for suicide in an outpatient pediatric psychiatry clinic serving an urban low-income Latino community.
The alert was developed for the clinic’s EHR, Allscripts. The goal of the alert was to remind clinicians to complete a safety plan whenever they documented that their patient endorsed suicidal ideation, plan, or attempt during a visit in their EHR notes. The alert appeared as a separate window containing a reminder message to complete a safety plan once a clinician finished documentation of the visit. Clinicians received one of three preset messages, which was determined using a Medical Logic Module.
We evaluated the EHR alert by comparing the number of safety plans authored for at risk patients during the intervention period with those authored during a historical control period. A patient was deemed at risk if a clinician indicated that the patient endorsed suicidal ideation, plan, or attempt during their last visit in the progress note, treatment plan, or evaluation notes. There were 95 at risk patients between the ages of 4-21 in the intervention period (M=14.22; SD=3.06; 62% female) and 99 (M=13.22; SD=3.47; 56% female) in the control period. Logistic regression analyses indicated that patients in the intervention period were significantly more likely than patients in the control period to receive a safety plan (p=.010). Forty clinicians also completed a questionnaire assessing their satisfaction with the EHR alert. Clinicians reported a moderate amount of satisfaction with the alert (M=3.22; SD=1.44; Range=1.11-11.00).
This study provides evidence that EHR alerts can be used to alter clinician behavior and improve compliance with best clinical practices for at risk youth.
Assistant Professor and Clinical Psychologist
New York State Psychiatric Institute/Columbia University Medical Center
Friday, November 17
3:30 PM – 5:00 PM
Sunday, November 19
8:30 AM – 10:00 AM
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