983 / Case Management Program for patients discharged from an emergency department after a suicide attempt

SPAIN
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Suicide / Self-mutilation
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Topic of the reported practice
Patient safety system
Aim and the benefit of the Patient Safety Practice
 
To reduce the risk of repeating a suicide attempt after being discharged from the emergency department
Description of the Patient Safety Practice
 
This program was implemented in Mental Health Service of Consorci Hospitalari de Vic in October 2012.
Suicide attempt is the most predictive factor to suicide since 50% of deaths by suicide had previous suicide attempt.
There are several studies demonstrating effectiveness of psychiatric telephone contact programs after discharge, reducing suicide retry attempts and promoting therapeutic compliance. The program consists in a first face visit the following week after the suicide attempt. Then, there is a telephonic visit at the first month, at 3, 6 and 12 months after suicide attempt. In all visits suicide risk is evaluated and the patient is sent to the most appropiate health service. The program is conducted by a nurse specialized in mental health. Patients admitted to the psychiatric unit are excluded as well as patients in intensive psychiatric health programs. Rest of patients are admitted (in all cases voluntary). In the first year of implemention of the program 93 suicide attempts were registered in a total of 81 patients. 75% of the candidate patients were included to the program.
2,12% of the patients included in the program retried suicide attempt while 20,58% of the patients not included retried. 12 patients were discharged from the program.
Attachment of relevant written information and/or photos, as appropriate
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
No published yet
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Health care context where the Patient Safety Practices was implemented
 
Mental health care
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
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Successful implementation's level  of this Patient Safety Practice across settings
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Involved health care staff
 
Physicians
Nurses
Therapists
Social workers
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Yes
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
Patient(s)
Point of time in which service user or their reprasentatives' involvement takes place
During the development of the Patient Safety Practices
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
Yes
Short description of the service users' level of involvement
Consultation, such as asking for information
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
Information sheet given at the emergency department discharge
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Management support
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
Yes
Description of used incentives, if any.
Achievieng the results of this project are paid (incentive-outcomes management)
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
Yes
Total number of person days required to implement this Patient Safety Practice
Clinical staff: 0,25
External consultants: 0
Support staff: 0
Managerial staff: 0,25
Others: 0
Not relevant: 0
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: 6
External consultants: 3
Support staff: 0
Managerial staff: 6
Others: 0
Not relevant: 0
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
0
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
0
Contact information
 
Name: Francesc Arrufat
Country: SPAIN
Organisation: Consorci Hospitalari de Vic
E-mail: farrufat@chv.cat
Phone: 93 889 11 11
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