Emergency Department Safety Assessment & Follow-up Evaluation (ED-SAFE)

Tuesday, June 16, 2015

Situation

In June 2010, the National Institute of Mental Health (NIMH) provided funds for UMass Medical School to conduct a quasi-experimental clinical trial on suicide prevention in eight emergency departments. The study is led by Edwin D. Boudreaux, PhD, Professor of Emergency Medicine, Psychiatry, and Quantitative Health Sciences at the Medical School.

The major goals of the Emergency Department Safety Assessment & Follow-up Evaluation (ED-SAFE) are to examine the feasibility and potential impact of screening emergency department patients for suicide risk; to examine the effect of an emergency department-initiated intervention to reduce suicidal behavior and associated problems; and to complete a comparative analysis across three phases of data collection – treatment as usual, universal screening, and intervention.

Solution

In collaboration with the ED-SAFE team, the Office of Survey Research collected data for each of the three study phases. A follow-up telephone protocol was implemented to assess study subjects enrolled in each phase at five distinct points in time. The Office of Survey Research’s activities included:

  • Training and certifying all interview staff in the Columbia Suicide Severity Rating Scale (C-SSRS).
  • Conducting more than 4,000 computer-assisted telephone interviews in English and Spanish over the course of approximately four years.
  • Engaging subjects through mail and electronic correspondence to ensure continued participation.
  • Implementing rigorous safety protocols within the calling system to allow interviewers to identify and transfer at-risk subjects to crisis center counselors.

Results

Data collection for the third and final phase ended in November 2014. To date, data from the follow-up surveys have been analyzed by the researchers to suggest best practices in detecting suicide-related adverse events. It is anticipated that results from ED-SAFE will eventually assist emergency departments in providing more effective care to patients who have suicidal thoughts or behaviors.