Analysis of the utility of a suicide risk assessment in an A&E setting
Research type
Research Study
Full title
Analysis of the utility of a suicide risk assessment in an A&E setting
IRAS ID
115093
Contact name
Elizabeth McKiernan
Contact email
Sponsor organisation
LTHTR
Research summary
“Would the use of a ratified suicide risk assessment proforma in A&E potentially reduce waiting times for patients presenting to A&E with para-suicide?”
In September 2012, 79 patients presented to Chorley A&E with psychiatric problems, most commonly para-suicide (attempt of suicide/ significant self-harm or thoughts of suicide/ significant self-harm). Often patients were referred to psychiatry before a risk assessment had been performed. Patients waited on average one to two hours for psychiatric assessment and eight remained in A&E longer than four hours. 15 patients (19%) were admitted or reviewed by the crisis team and 64 (81%) were discharged to their GP or referred to outpatient psychiatry.
In this prospective cohort study A&E doctors will perform a suicide risk assessment on all patients presenting to A&E with para-suicide using a ratified suicide risk assessment proforma and their clinical judgement. They will assign patients to low, medium or high risk categories and indicate the theoretical management they feel most appropriate (admission/ crisis follow-up/ outpatient referral/ discharge to GP/ other). All patients will be assessed by psychiatry as usual. Theoretical A&E outcomes will be compared with actual outcomes.
Waiting times will be collected including: time to first assessment, time to psychiatric assessment and time to discharge. This data will be used to identify whether there would be any benefit in A&E doctors performing risk assessments before referring to psychiatry if necessary.
Patients will receive the same care as usual. The proforma is a series of tick-boxes, therefore, no sensitive data will be collected, NHS numbers (recorded for the purpose of identifying outcomes) will converted to reference numbers to protect confidentiality.
Potential future benefits will be to the hospital (costs), staff (workload) and patients (waiting times). The study itself will not cause direct harm or give direct benefit to patients involved.
REC name
North West - Preston Research Ethics Committee
REC reference
13/NW/0386
Date of REC Opinion
24 Jun 2013
REC opinion
Further Information Favourable Opinion