Virtual monitoring of suicide risk in the general hospital and emergency department

David S Kroll¹, Escel Stanghellini², Stephanie L DesRoches², Charles Lydon², Allison Webster², Molly O'Reilly³, Shelley Hurwitz⁴, Patricia M Aylward², Jennifer A Cartright², Elizabeth J McGrath², Linda Delaporta², Anna T Meyer², Michael S Kristan², Laurie J Falaro², Colin Murphy³, Jennifer Karno⁵, Daniel J Pallin⁶, Adam Schaffer⁴, Sejal B Shah⁷, Barbara E Lakatos², Monique T Mitchell², Christine A Murphy², Janet M Gorman², David F Gitlin⁷, Deborah F Mulloy⁸

Affiliations

¹ Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA; Harvard Medical School, 250 Longwood Ave, Boston, MA 02115, USA. Electronic address: dskroll@bwh.harvard.edu.
² Department of Nursing, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA.
³ Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA.
⁴ Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA; Harvard Medical School, 250 Longwood Ave, Boston, MA 02115, USA.
⁵ Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA; Division of Social Work, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA.
⁶ Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA; Harvard Medical School, 250 Longwood Ave, Boston, MA 02115, USA.
⁷ Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA; Harvard Medical School, 250 Longwood Ave, Boston, MA 02115, USA.
⁸ Massachusetts Board of Registration in Medicine, 200 Harvard Mill Square, Wakefield, MA 01880, USA.

PMID: 30665667
DOI: 10.1016/j.genhosppsych.2019.01.002

Virtual monitoring of suicide risk in the general hospital and emergency department

David S Kroll et al. Gen Hosp Psychiatry. 2020 Mar-Apr.

. 2020 Mar-Apr:63:33-38.

doi: 10.1016/j.genhosppsych.2019.01.002. Epub 2019 Jan 14.

Authors

Affiliations

¹ Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA; Harvard Medical School, 250 Longwood Ave, Boston, MA 02115, USA. Electronic address: dskroll@bwh.harvard.edu.
² Department of Nursing, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA.
³ Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA.
⁴ Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA; Harvard Medical School, 250 Longwood Ave, Boston, MA 02115, USA.
⁵ Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA; Division of Social Work, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA.
⁶ Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA; Harvard Medical School, 250 Longwood Ave, Boston, MA 02115, USA.
⁷ Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02125, USA; Harvard Medical School, 250 Longwood Ave, Boston, MA 02115, USA.
⁸ Massachusetts Board of Registration in Medicine, 200 Harvard Mill Square, Wakefield, MA 01880, USA.

PMID: 30665667
DOI: 10.1016/j.genhosppsych.2019.01.002

Abstract

Objective: To determine whether continuous virtual monitoring, an intervention that facilitates patient observation through video technology, can be used to monitor suicide risk in the general hospital and emergency department (ED).

Method: This was a retrospective analysis of a protocol in which select patients on suicide precautions in the general hospital and ED received virtual monitoring between June 2017 and March 2018. The primary outcome was the number of adverse events among patients who received virtual monitoring for suicide risk. Secondary outcomes were the percentage of patients for whom virtual monitoring was discontinued for behavioral reasons and the preference for observation type among nurses.

Results: 39 patients on suicide precautions received virtual monitoring. There were 0 adverse events (95% confidence interval (CI) = 0.000-0.090). Virtual monitoring was discontinued for behavioral reasons in 4/38 cases for which the reason for terminating was recorded (0.105, 95%CI = 0.029-0.248). We were unable to draw conclusions regarding preference for observation type among nurses due to a low response rate to our survey.

Conclusions: Suicide risk can feasibly be monitored virtually in the general hospital or ED when their providers carefully select patients for low impulsivity risk.

Keywords: Constant observation; Quality improvement; Safety; Suicide.

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Virtual monitoring of suicide risk in the general hospital and emergency department

Affiliations

Virtual monitoring of suicide risk in the general hospital and emergency department

Authors

Affiliations

Abstract

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources