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Screen for substance abuse when assessing suicide risk

Quality Improvement Monitor, June 15, 2007

Patients coming into the emergency department (ED) with substance abuse problems should go through a rigorous alcohol screening to determine whether they are at risk for suicide.

"We do ask questions about drinking," says Yosef Dlugacz, PhD, senior vice president and chief of clinical quality, education, and research at the Krasnoff Quality Management Institute, North Shore-Long Island Jewish Health System (NS-LIJHS) in Great Neck, NY. "If there is a problem, then we go to a more comprehensive assessment that focuses on alcohol withdrawal."

Dlugacz' health system knows full well that alcohol withdrawal can lead to suicide, one of The Joint Commission's top sentinel events.

Between 1998 and 2001, the organization, the third largest health system in the country, started a performance improvement project to prevent suicide. As part of that project, NS-LIJHS completed root-cause analyses of 17 attempted and completed suicides for inpatient acute care, outpatient, and inpatient behavioral health clinical settings.

That project-and the protocols, education, and tools to which it led-has positioned the organization well to comply with The Joint Commission's 2007 National Patient Safety Goal (NPSG) 15 and assess high risk patients for suicide.

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