(PS11-13) Assessing the Use of Safety Planning for Suicide Risk Reduction Among Hospital Providers

Suicide risk in hospital settings is a major concern and effective resources to assess and reduce risk are paramount. The Safety Planning Intervention (SPI; Stanley & Brown, 2008) is a brief (~30 minute), evidence-based intervention for preventing future suicidal behavior; however, its frequency of use in real-world clinical settings is unclear. Moreover, varying levels of clinician training and lack of standardization in delivery of evidence-based interventions in healthcare settings can pose challenges to effective implementation. We developed a quality improvement survey to determine current use of, and training in, the SPI among all psychiatry department providers (including MDs, PhDs, MSW/LICSWs, and RNs) at a Boston-based hospital. We aimed to assess providers’ current utilization, interest in learning more about the SPI, and barriers, facilitators, and other considerations regarding the real-world use of this evidence-based intervention. The survey was administered via REDCap and consisted of fifteen questions. It was circulated via an email invitation to all providers on the department listserv to complete a brief, anonymous survey assessing providers’ views on how and whether the SPI could be accessible and effective in their clinical practice. Sample questions included, “How confident are you in providing care to patients with current or recent suicidal thoughts or behaviors?” and, after providing a brief description of the SPI and its evidence base, “Have you ever received training in the SPI?”. Participation was incentivized with raffle entry. The survey was completed by 193 providers (approx. 23% response rate). The sample analyzed includes N=189 respondents (35.1% MDs, 30% PhDs, 22.8% trainees, 6.1% nurses, and 6% social workers), as four identified as non-clinicians. Results demonstrate that under one-third (31.2%) of providers use the SPI. Over half (58%) of providers had not received any formal training in the SPI. Those who had received SPI training were both more likely to use the intervention [X² (1, N = 189) = 37.37, p < .001] and more confident providing care to suicidal patients [X² (1, N = 189) = 5.66, p < .05]. About 95% of providers expressed interest in learning more about the SPI. Providers indicated several facilitators to implement SPI in their practice, namely accessibility through the electronic health record (EHR) and developing clear recommendations about when/how to use the SPI. Despite the empirical support for and relative ease of delivering the SPI, survey results indicated relatively low use of this evidence-based intervention in a hospital psychiatry department. Findings suggest the need for provider trainings and other resources to support more systematic delivery of the SPI in this hospital setting, including standardized EHR modules to support delivery and documentation. Future considerations within a learning health system framework include assessing provider outcomes (e.g., fidelity, use) following systematic training, as well as patient-level outcomes (e.g., rate of suicide attempts).