Jennifer M Boggs, Bobbi Jo H Yarborough, Gregory Clarke, Erica M Aguirre-Miyamoto, Lee J Barton, Arne Beck, Cambria Bruschke, Stuart Buttlaire, Karen J Coleman, Jean P Flores, Robert Penfold, J David Powers, Julie Angerhofer Richards, Laura Richardson, Arthur Runkle, Jacqueline M Ryan, Gregory E Simon, Stacy Sterling, Christine Stewart, Scott Stumbo, LeeAnn M Quintana, Hsueh-Han Yeh, Brian K Ahmedani
{"title":"Development and Validation of Electronic Health Record Measures of Safety Planning Practices as Part of Zero Suicide Implementation.","authors":"Jennifer M Boggs, Bobbi Jo H Yarborough, Gregory Clarke, Erica M Aguirre-Miyamoto, Lee J Barton, Arne Beck, Cambria Bruschke, Stuart Buttlaire, Karen J Coleman, Jean P Flores, Robert Penfold, J David Powers, Julie Angerhofer Richards, Laura Richardson, Arthur Runkle, Jacqueline M Ryan, Gregory E Simon, Stacy Sterling, Christine Stewart, Scott Stumbo, LeeAnn M Quintana, Hsueh-Han Yeh, Brian K Ahmedani","doi":"10.1080/13811118.2024.2394676","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Safety planning for suicide prevention is an important quality metric for Zero Suicide implementation. We describe the development, validation, and application of electronic health record (EHR) programs to measure uptake of safety planning practices across six integrated healthcare systems as part of a Zero Suicide evaluation study.</p><p><strong>Methods: </strong>Safety planning was documented in narrative notes and structured EHR templates using the Stanley Brown Safety Planning Intervention (SBSPI) in response to a high-risk cutoff score on the Columbia Suicide Severity Rating Scale (CSSRS). Natural Language Processing (NLP) metrics were developed and validated using chart review to characterize practices documented in narrative notes. We applied NLP to measure frequency of documentation in the narrative text and standard programming methods to examine structured SBSPI templates from 2010-2022.</p><p><strong>Results: </strong>Chart reviews found three safety planning practices documented in narrative notes that were delivered to at least half of patients at risk: professional contacts, lethal means counseling for firearms, and lethal means counseling for medication access/storage. NLP methods were developed to identify these practices in clinical text with high levels of accuracy (Sensitivity, Specificity, & PPV ≥ 82%). Among visits with a high-risk CSSRS, 40% (Range 2-73% by health system) had an SBSPI template within 1 year of implementation.</p><p><strong>Conclusions: </strong>This is one of the first reports describing development of measures that leverage electronic health records to track use of suicide prevention safety plans. There are opportunities to use the methods developed here in future evaluations of safety planning.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Suicide Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13811118.2024.2394676","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Safety planning for suicide prevention is an important quality metric for Zero Suicide implementation. We describe the development, validation, and application of electronic health record (EHR) programs to measure uptake of safety planning practices across six integrated healthcare systems as part of a Zero Suicide evaluation study.
Methods: Safety planning was documented in narrative notes and structured EHR templates using the Stanley Brown Safety Planning Intervention (SBSPI) in response to a high-risk cutoff score on the Columbia Suicide Severity Rating Scale (CSSRS). Natural Language Processing (NLP) metrics were developed and validated using chart review to characterize practices documented in narrative notes. We applied NLP to measure frequency of documentation in the narrative text and standard programming methods to examine structured SBSPI templates from 2010-2022.
Results: Chart reviews found three safety planning practices documented in narrative notes that were delivered to at least half of patients at risk: professional contacts, lethal means counseling for firearms, and lethal means counseling for medication access/storage. NLP methods were developed to identify these practices in clinical text with high levels of accuracy (Sensitivity, Specificity, & PPV ≥ 82%). Among visits with a high-risk CSSRS, 40% (Range 2-73% by health system) had an SBSPI template within 1 year of implementation.
Conclusions: This is one of the first reports describing development of measures that leverage electronic health records to track use of suicide prevention safety plans. There are opportunities to use the methods developed here in future evaluations of safety planning.
期刊介绍:
Archives of Suicide Research, the official journal of the International Academy of Suicide Research (IASR), is the international journal in the field of suicidology. The journal features original, refereed contributions on the study of suicide, suicidal behavior, its causes and effects, and techniques for prevention. The journal incorporates research-based and theoretical articles contributed by a diverse range of authors interested in investigating the biological, pharmacological, psychiatric, psychological, and sociological aspects of suicide.