Citation

Parast L, Bardach NS, Burkhart Q, Richardson LP, Murphy JM, Gidengil CA, Britto MT, Elliott MN, Mangione-Smith R. Acad. Pediatr. 2018; 18(3): 248-255.

Affiliation

Seattle Children's Research Institute, 4800 Sand Point Way NE, Seattle, WA 98105; Department of Pediatrics, University of Washington/Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105.

Copyright

(Copyright © 2018, Academic Pediatric Association, Publisher Elsevier Publishing)

DOI

10.1016/j.acap.2017.09.017

PMID

29100860

Abstract

OBJECTIVES: To develop, validate, and test the feasibility of implementation of four new quality measures assessing ED and inpatient care for suicidal youth.

METHODS: Four quality measures were developed to assess hospital-based care for suicidal youth. These measures, focused on counseling caregivers about a) restricting access to lethal means of self-harm and b) benefits and risks of anti-depressant medications, were operationalized into 2 caregiver surveys, assessing ED and inpatient quality, respectively. Survey field tests included caregivers of youth who received inpatient and/or ED care for suicidality at one of two children's hospitals between 7/2013-6/2014. We examined the feasibility of obtaining measure scores and variation in scores. Multivariate models examined associations between quality measure scores and four validation metrics: modified Child Hospital Consumer Assessments of Health Care Providers and Systems(©) communication composites, hospital readmissions, and ED return visits.

RESULTS: Response rates were 35% (ED) and 31% (inpatient). Most caregivers reported receiving counseling to restrict their child's access to lethal means of self-harm (90% in the ED and 96% in the inpatient setting). In the inpatient setting, caregivers reported higher rates of counseling on benefits (95%) of newly prescribed anti-depressants than risks (physical side effects 85%, increased suicidality 72%). Higher scores on the latter measure were associated with higher nurse (p<0.001) and doctor (p<0.01) communication composite scores. Measure scores were not associated with readmissions or ED return visits.

CONCLUSIONS: These new quality measures evaluate key aspects of care for suicidal youth, and may facilitate assessing quality of care for this vulnerable population.

Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

measure development,; pediatric quality measures; suicidality,