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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV1301

Improving the recognition of acute suicide risk: system-level implementation of Suicide Crisis Syndrome in inpatient care

IMPROVING IDENTIFICATION OF ACUTE SUICIDE RISK: SYSTEM-LEVEL IMPLEMENTATION OF SUICIDE CRISIS SYNDROME IN INPATIENT CARE

System-level implementation of Suicide Crisis Syndrome in inpatient units significantly increased syndrome-specific documentation without changing traditional suicide risk indicators.

The study aimed to evaluate the implementation of Suicide Crisis Syndrome (SCS), an evidence-based acute state associated with near-term suicide risk, across six adult inpatient units in a large urban health system, using Proctor and colleagues’ implementation outcomes framework. Five data sources were used: electronic health record suicide risk assessments (SRAs) comprising 39 suicide risk items, 11 of which assessed SCS; pre- and post-implementation clinician surveys; transcripts of three focus groups (n = 8, n = 6, n = 2) and four interviews; and unrecorded stakeholder meetings. Independent-samples t-tests were used for continuous variables and chi-square tests for categorical variables in the SRA data, with a sample encompassing 4,382 admissions; transcripts were examined by two raters using reflexive thematic analysis. Following implementation, the total SCS score increased from 1.12 (SD 1.53) to 1.22 (SD 1.61) (t(4377) = -2.18; p = 0.030; effect size d = -0.07), the number of SCS criteria met increased from 0.91 (SD 1.13) to 1.00 (SD 1.21) (t(4377) = -2.76; p = 0.006; d = -0.09), and the SCS diagnosis rate increased from 3.2% (n = 86) to 4.5% (n = 77) (chi-square(1) = 5.17; p = 0.023; V = 0.03); the pre-implementation sample comprised 2,683 assessments and the post-implementation sample 1,696 assessments. This change remained specific to SCS, with no change in the documentation of traditional suicide risk indicators, and the effect remained significant after adjustment for age, race, and site. Qualitative findings indicated that the administrative burden supported the need for a brief scale, that the existing SRA contributed to clinician stress, that staff were receptive to using SCS, and that management approved SCS as a research diagnosis in the electronic health record system. The authors concluded that implementation was feasible and acceptable to stakeholders, with early evidence of sustainability; limitations included the fact that SRA documentation captured only positive responses and that unchecked fields could not distinguish between symptoms assessed as absent and symptoms that had not been assessed.

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