J Psychiatr Pract. 2021 May 5;27(3):164-171. doi: 10.1097/PRA.0000000000000548.
The objective of this study was to use quantitative and qualitative data to gather information about emergency medicine and psychiatric provider perspectives regarding the evolution of a violence risk screening process including the simultaneous implementation of a universal suicide screening program.
A retrospective review of violence risk screening data for 496 patient encounters over a 2-year period and across 4 phases of implementation and improvement was completed. Four focus groups were conducted with emergency medicine and psychiatric providers using nondirective facilitation methods to gather data regarding provider perspectives about violence and suicide risk screening. The focus groups were recorded, transcribed, and analyzed for thematic content.
Four of the 6 violence risk screening items were most strongly associated with high-risk stratification across all phases. There were no changes in proportions of positive responses for 3 of the items. The proportion of positive responses for the other items changed significantly after expert feedback and clarification of item wording. Only 3% of the focus group passages included discussion of the universal suicide screening program.
The providers indicated that they believed the violence risk screening and suicide screening procedures helped improve clinical thoroughness and documentation. Ongoing feedback between providers and program developers was beneficial. The implementation of the universal suicide screening process was relatively seamless for these providers.
本研究旨在利用定量和定性数据，收集有关急诊医学和精神科提供者对暴力风险筛查过程演变的观点信息，包括同时实施普遍的自杀筛查计划。
对 496 例患者在 2 年期间和实施和改进的 4 个阶段中的暴力风险筛查数据进行回顾性审查。采用非指导性促进方法对急诊医学和精神科提供者进行了 4 次焦点小组讨论，以收集有关提供者对暴力和自杀风险筛查的观点数据。对焦点小组进行了录音、转录和主题内容分析。
在所有阶段，有 6 个暴力风险筛查项目中的 4 个与高危分层最密切相关。其中 3 个项目的阳性反应比例没有变化。在专家反馈和项目措辞澄清后，其他项目的阳性反应比例发生了显著变化。只有 3%的焦点小组讨论涉及普遍的自杀筛查计划。
提供者表示，他们认为暴力风险筛查和自杀筛查程序有助于提高临床彻底性和记录的完整性。提供者和项目开发人员之间的持续反馈是有益的。对于这些提供者来说，普遍的自杀筛查过程的实施相对顺利。
