ED STOP Suicide Collaborative

ED Stop Suicide

Purpose

To optimize the clinical care processes for children and adolescents presenting to the ED with acute suicidality.


Overview

In late 2021, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association collectively declared a National State of Emergency in Children’s Mental Health. The organizations called out the need to “address the ongoing challenges of the acute care needs of children and adolescents, including shortage of beds and emergency room boarding,” a situation that was further exacerbated by the COVID-19 pandemic.

In recognition that many EDs across the nation are overwhelmed by the rate of children and adolescents presenting with mental health emergencies, the Emergency Medical Services for Children (EMSC) program designed the ED STOP Suicide Collaborative. The purpose of this collaborative is to bring together ED-based teams from across the nation with experts in pediatric mental health to exchange evidence-based best practices and optimize the care and follow-up of children and adolescents presenting with acute suicidality.


Why Join

No effort to improve the care processes for children and adolescents presenting with acute suicidality is too small to make an impact. This quality improvement (QI) collaborative will provide an opportunity for ED-based teams to collaborate with other diverse teams across the country. Participants will have access to evidenced-based best practices, collaborative educational sessions, resources, coaching by pediatric mental health experts, and networking opportunities to improve the care of children and adolescents in their community – at no cost.

Teams will be supported in evaluating and improving clinical care processes within their ED. Teams will be encouraged to select an area of focus, implement an improvement strategy, and evaluate progress.


Who Should Participate

The collaborative is open to teams of healthcare professionals interested in working together to improve care processes for children and adolescents presenting with acute suicidality. Teams should identify one or more acute care hospitals or freestanding EDs to focus improvement efforts. Teams should include at least two individuals affiliated with the same institution. These individuals should care for (or be willing to care for) children and adolescents presenting to the site’s ED with mental/behavioral health emergencies. The core group might include physicians, nurses, social workers, mental health professionals, child life specialists, or sitters (medical watch personnel) who work within an ED. The team may expand, especially to work collaboratively on a QI project, to include others, such as patient/family advisory board representatives or community-based partners (e.g., mental health professionals, pediatricians, or school officials).

Sites are encouraged to promote participation in the collaborative across their hospital system and/or amongst neighboring hospitals and freestanding EDs. EMSC State Partnership program managers are welcome to participate in the collaborative to learn, support, and help identify resources to guide local and regional efforts.


Structure

The initial phase of the collaborative will consist of monthly, one-hour deep-dive sessions that will focus on quality improvement strategies as well as evidence-based clinical considerations (screening, assessment, interventions, and follow-up) and approaches (in-person vs telehealth). Teams should plan to have one or more members regularly attend these learning sessions where to exchange ideas, challenges, and successes.

The sessions will occur on the first Thursday of each month, with fewer sessions over the summer months to allow for more focused work on a team-specific quality improvement project.  Teams will have the opportunity for regular check-ins and support throughout the entire collaborative.


Time Commitment

Participants should plan to attend a one-hour virtual learning session each month. Optional coaching sessions and fireside chats with experts will also be offered. Sessions will be recorded for participants who cannot make the live events.

In addition to the monthly learning sessions, teams should aim to implement a local quality improvement project. Participants should estimate one additional hour per week for meeting with their internal team, selecting an improvement idea, testing the change, and reflecting on progress.

The total time commitment may range from 2 to 6 hours per month, depending on the time the team members want to contribute to the QI project.


Quality Improvement Project

After performing a brief needs assessment, teams will be offered the opportunity to implement a basic QI project focused on one or more specific components of the care process: screening, mental health assessment, ED-based interventions, discharge and disposition, or community linkages. Educational materials referred to as improvement bundles have been developed for each of these care processes to help guide teams.

Teams will be asked to present their progress and discuss challenges with fellow participants during select monthly learning sessions. In addition, every site will be asked to complete a brief monthly progress report form.


Incentives

Continuing nursing education (CNE) and Maintenance of Certification Part 4 (MOC Part 4) credit hours will be available. Education credits for social workers are being explored: live attendance at the learning sessions and completion of a post-session evaluation is required for individual credit.