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



Status:Completed
Conditions:Hospital, Psychiatric
Therapuetic Areas:Psychiatry / Psychology, Other
Healthy:No
Age Range:18 - Any
Updated:3/15/2019
Start Date:July 2010
End Date:November 2018

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The NIMH s RFA-Suicide Prevention in Emergency Medicine Departments recognizes the emergency
department (ED) as an important setting to increase suicide detection and prevention efforts
but observes that evidence-based practice guidelines do not exist. In response, we have
designed the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) trial.
The ED-SAFE study will be conducted using a quasi-experimental design appropriate for
studying systems-based change. The study consists of two components (Screening Outcome &
Intervention Evaluation) and three phases of data collection: Treatment as Usual, Screening
Alone, and Intervention. During each phase, 480 suicidal patients (1,440 total) will be
enrolled and followed using multiple methods for 12 months.

The Screening Outcome Component

The Screening Outcome component will use data collected during the Treatment as Usual and
Screening Alone phases. Consistent with systems-change principles, when universal screening
is incorporated during the Screening Alone phase, it will be completed by the primary nurse
as part of routine care. Primarily, it will focus on testing a practical approach to screen
ED patients for suicidal ideation and behavior and will assess its impact on suicide
detection, process outcomes, and suicide behaviors.

Intervention Evaluation Component

The Intervention Evaluation component will use data from the Treatment as Usual, Screening
Alone, and Intervention Phases. During the Intervention phase, each ED will implement a
multi-component, systems-based Intervention called the Safety Assessment and Follow-up
Telephone Intervention (SAFTI). The SAFTI will combine elements of: (a) safety planning
administered by nursing staff in the ED, and (b) Coping Long Term with Active Suicide Program
(CLASP)-ED, a series of up to 7 semi-structured telephone advising calls to the patient and 4
to the significant other over the 12 months after the ED visit. Safety planning will be
implemented universally to all suicidal patients, regardless of whether they are ultimately
enrolled into the trial, as part of a comprehensive suicide management protocol (e.g., it is
a systems-based change). However, for practical and budgetary considerations, the CLASP-ED
telephone advising calls will be administered only to participants enrolled into the study.

Our overarching hypotheses will be tested using a combination of the Screening Outcome
component and the Intervention Evaluation Component. We predict that screening will improve
detection of suicidal ideation, and the intervention will enhance the quality of care and
reduce suicide outcomes.

see summary above

Inclusion Criteria:

- Over 18,

- Entering care at a hospital ED,

- Documented thoughts or behaviors related to self-harm.

Exclusion Criteria:

- No phone or permanent address,

- Does not speak English or Spanish.
We found this trial at
8
sites
Little Rock, Arkansas 72205
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330 Brookline Ave
Boston, Massachusetts 02215
617-667-7000
Beth Israel Deaconess Medical Center Beth Israel Deaconess Medical Center (BIDMC) is one of the...
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12605 East 16th Avenue
Aurora, Colorado 80045
720-848-0000
University of Colorado Hospital, Site Top medical professionals, superior medicine and progressive change make University...
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Columbus, OH
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Emile St
Omaha, Nebraska 68198
(402) 559-4000
Univ of Nebraska Med Ctr A vital enterprise in the nation’s heartland, the University of...
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Omaha, NE
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111 Brewster St
Pawtucket, Rhode Island 02860
(401) 729-2000
Memorial Hospital of Rhode Island Memorial Hospital of Rhode Island is a 294-bed community teaching...
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Phoenix, Arizona 85008
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Phoenix, AZ
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Worcester, Massachusetts 01655
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Worcester, MA
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