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Zero Suicide Organizational Self-Study (Healthcare Provider)

Background:

The organizational self-study is designed to allow you to assess what components of the comprehensive Zero Suicide approach your organization currently has in place. The self-study can be used early in the launch of a Zero Suicide initiative to assess organizational strengths and weaknesses and to develop a work plan. Later in your implementation efforts, the self-study can be used as a fidelity check to determine how closely the components of the Zero Suicide model are being followed and as an opportunity to identify areas for improvement. We recommend taking the self-study at launch and then at 12-month intervals. Staff involved in the policymaking for and care of patients at risk for suicide should complete the self-study as part of an implementation team. The team should complete this tool together during one of their initial meetings. While the self-study is not exhaustive with regard to all issues that can affect patient care and outcomes, it does reflect components that define the Zero Suicide approach. For more information or clarification regarding any of the items in this self-study, please visit zerosuicide.com. Each component of the Zero Suicide model is measured on a rating scale from 1 to 5, described below. The scale is intended to balance minimal reporting burden with measuring implementation for the most essential parts of the model. This tool should be completed by members of the implementation team who are responsible for developing and implementing the organization’s Zero Suicide initiative.
Person Completing Information
Number of staff involved with self-study completion
County(ies) served
1. Create a leadership-driven, safety-oriented culture:

What type of commitment has leadership made to reduce suicide and provide safer suicide care?

This item refers to the development of formal policies, processes, or guidelines in one or more of the following areas:

• Workforce training
• Suicide screening
• Suicide risk assessment and risk formulation
• Suicide care management plan
• Safety planning
• Lethal means reduction
• Evidence-based treatment
• Contact with patients with known suicide risk who don’t show for appointments
• Follow-up with patients with known suicide risk during care transitions or following discharge
1. What type of commitment has leadership made to reduce suicide and provide suicide prevention services? Overall Rating:
2. Leadership commitment to Screening for suicide:
3. Leadership commitment to Assessment of suicide risk:
4. Leadership commitment to Lethal means safety:
5. Leadership commitment to Safety planning:
6. Expectation for suicide care management plan for those with suicidal thoughts or behavior:
Create a leadership-driven, safety-oriented culture:
7. What type of formal commitment has leadership made regarding staffing to reduce suicide and to provide safer suicide prevention and intervention?
Create a leadership-driven, safety-oriented culture:
8. What is the role of suicide attempt and suicide loss survivors in the organization’s design, implementation, and improvement of suicide prevention and intervention policies and services?
Develop a competent, confident, and caring workforce:
9. How does the organization formally assess staff on their perception of their confidence, skills, and perceived support to identify and care for individuals at risk for suicide?
Develop a competent, confident, and caring workforce:
10a. What introductory trainings on identifying people at risk for suicide or providing suicide prevention and intervention services have been provided to staff?
10b. Please indicate the training approach or curriculum the organization uses to train staff on suicide risk identification and prevention and intervention (select all that apply):
10c. Please indicate the minimum number of hours of training on suicide:
Develop a competent, confident, and caring workforce:
11a. What advanced training on identifying people at risk for suicide, suicide assessment, risk formulation, and ongoing intervention has been provided to staff?
11b. Please indicate the training approach or curriculum the organization uses to train clinical staff on advanced suicide prevention skills (select all that apply):
Systematically identify and assess suicide risk:
12. What are the organization’s policies or procedures for screening for suicide risk among individuals you serve?
Systematically identify and assess suicide risk:
13a. How does the organization screen for suicide risk in the people it serves?
13b. If a suicidality screening tool is used, the screener used:
Systematically Screen and Assess Suicide Risk
14. How does the organization ensure assessments for suicide risk are arranged for individuals who screen positive?
Ensure the Organization Has a Standard Set of Expectations for Programs and Interventions for Individuals Identified as at Risk for Suicide
15. Which best describes the organization’s approach to supporting and tracking individuals at risk for suicide?
A suicide care management plan should include the following:
• Screening
• Assessment and risk formulation
• Safety planning
• Lethal means restriction
• Evidence-based treatment
• Supportive contacts with patients who don’t show for appointments and during care transitions
Collaborative safety planning
16a. What is the organization’s approach to collaborative safety planning when an individual is at risk for suicide?
16b. Please indicate whether or not the organization uses the Stanley/Brown safety plan template:
16c. If no, identify the safety planning tool or approach the organization uses
16d. If applicable, how frequently is the safety plan reviewed with the individual?
Collaboratively Plan for Lethal Means Safety
17. What is the organization’s approach to lethal means safety?
Refer Individuals to Providers Who Use Effective, Evidence-Based Treatments That Directly Target Suicidal Thoughts and Behaviors
18. What is the organization’s approach to referring individuals for treatment of suicidal thoughts and behaviors?
Provide Continuous Contact and Support
19. What is the organization’s approach to engaging hard-to-reach individuals or those who are at risk and don’t show for expected services?
Apply a Data-Driven Quality Improvement Approach
20. What is the organization’s approach to quality improvement efforts related to suicide
prevention services?
21. If you wish to describe or elaborate on any item, please do so in the space provided below.