Objective 12.2:
Improve care and follow-up provided on presentation at MNHHS EDs, and on hospital discharge, to people experiencing a suicidal crisis, or who have attempted suicide.
Action 12.2.1:
Implement the Zero Suicide in Healthcare Multi-site Collaborative
Summary of activity
Zero Suicide in Redcliffe-Caboolture started with a pledge – a commitment to creating a culture of Zero Suicide because “even one suicide is one too many”.
A review of systems and processes found that Redcliffe and Caboolture Hospitals had limited procedures specific to suicide prevention and care including no formal guidance around safety planning and a lack of mandatory, standardised training to ensure clinicians shared baseline knowledge.
In response, Zero Suicide commenced in July 2018 across Redcliffe and Caboolture Hospitals.
Key achievements
Tailored to the specific needs of the Redcliffe and Caboolture regions, Zero Suicide comprised the following components:
- The development and implementation of a clinical pathway incorporating assertive follow-up
- The formal introduction of safety planning as part of the clinical pathway
- The rollout of comprehensive training for clinicians.
Zero Suicide has shown a demonstrable improvement in the confidence and comfort of hospital staff in effectively responding to people at risk of suicide.
One hundred and eighty-nine mental health professionals across the Redcliffe and Caboolture hospitals have completed suicide prevention training, representing almost three-quarters of the mental health clinical workforce, with 94.5% recommending the training to their colleagues. A workforce survey implemented 15 months following training shows increases across all positive domains relating to staff confidence and comfort to respond to and work with people at risk of suicide.
Key learnings
With a strong commitment to monitoring implementation, a number of adaptations have been made during the first year of implementation:
Reshaping of clinical pathway to meet client and health professional need
Feedback from consumers who were declining assertive follow up and safety planning, and feedback from hospital staff who reported difficulty in finding the time to assertively follow people up, indicated a perception that the pathway may not enhance existing practices in supporting people with chronic suicide risk. This feedback is being used to modify the pathway, with a relaunch scheduled for November 2019.
Updating of safety plan to improve useability and appropriateness
Feedback from both consumers and hospital staff suggested a number of barriers with the proposed safety plan, including its length, the time it takes to complete, and its accessibility for those with low levels of literacy. Guided by this feedback, the safety plan was refreshed with a greater focus on accessibility and enhancing functionality – for both the consumer and health professional.
What’s next?
Despite the Zero Suicide trial officially ending in December 2019, the Redcliffe and Caboolture Hospitals have displayed significant commitment to continuation of a dedicated focus on suicide prevention and care through several means:
- Recruitment of a Nurse Navigator focused on suicide prevention, who will embed the learnings from Zero Suicide into the Redcliffe and Caboolture Hospital’s normal processes
- Recruitment of Suicide Prevention Champions
- Expanding training to non-clinical and non-Mental Health Services staff
- Committing to a yearly training refresher for all staff.
