Albuquerque has officially initiated the monitor and we have gotten our first alert today! Also very grateful for Dr. Post's time and education, we have done extensive training with all of our staff regarding their closed loop communication. It is great that we can support our outpatient clinics this way, as well as catching direct admit transfers, unexpected post-procedure admits, discharge barriers, and just plain human error; there is a sieve of opportunity for misses. We had created our own manual process, but it was clunkier and required a few of us to scramble to diffuse the alerts as quickly as we could find them. This is so much smoother and allows for prompt communication across our teams.

Our Boise facility is in the process of implementing the +CSSRS monitor. On the very first day we practiced utilizing the tool (before we even officially began using it) our teams were able to identify what most certainly would have been a fallout, and then intervene to ensure a CSRE was completed same day. The success was extremely rewarding, and the teamwork and support that everyone felt was revitalizing. While I believe there'll always be a place for this kind of safety net, the goal as I see it is for the process to be one of education and support. We're hoping that through this process we're helping folks problem solve obstacles in ways that they will then utilize to manage future barriers on their own.

@ Julia Scott (thanks for your time talking today) AND other converted sites to Cerner: the Cerner EHR is better optimized already than what can be done with CPRS. specifically, the CSSRS screening Powerform which launches off recommendations (reminders) guides the screening staff after a positive screen, if they are not the one to complete the CSRE, to do closed loop communication meaning a warm-handoff about the positive screen to the provider for CSRE completion. this is similar to the screening pop-ups in CPRS with a similar message, but the form also validates the screener's entry of who they handed to, from a list of EHR users [which is not possible in CPRS], so all charted information has an added level of validity. furthermore, when there is a positive CSSRS a "Smart zone" alert is fixed in an area at the periphery of the screen for 24 hours to supplement the interprofessional communications in a much less intrusive manner (not intruding on the ability to use the workflow)--which makes all the difference in mitigating alert fatigue.

in my experience supporting information products and QI nationally in this area, this can easily create many serious problems in implementation. it clearly can de-emphasize the MANDATED person to person closed loop communication for ALL positive suicide screens. it is thus not directed to the dyad of screener and follow-up clinical staff member, rather it alerts many who interact with that patient chart. thus, it also adds to the global burden of alert fatigue which is an extremely serious problem in EHRs generally and CPRS in particular. therefore it is far from clear that this is a net positive on the multitude of clinical processes that transpire for any given patient.

I am interested in this platform, however we are a Cerner site. Any idea if this will work in Cerner? Thank you!

Reno is an Implementing Facility and I am one of the Fellows on the team. Within 3 days of going "live" with this monitoring tool, our team was able to catch and stop 2 fallouts. It has been a full week and one more potential fallout was stopped. Our team has been able to develop an effective way to support staff and warm-hand offs without them feeling like they were being micro managed and the Veteran receives the care they deserve without falling through the cracks.

I am interested in possibly implementing this at my facility, but I do have questions. I thought this metric had to be completed within 24 hours, so I am curious if that is true why the follow up at 36 hours would help you stay in compliance. Or have I been given incorrect information on the metric?

I recently assumed the role of Suicide Prevention Program Manager at this facility, and at first I was so worried about keeping track of all of the details. Learning how to use this tool took about five minutes, and it gives me such peace of mind. I know at any given moment which of our Veterans has screened positive for suicide risk, and I can ensure we have a plan to follow up with each one.

I am fortunately one of the initializing team members. This is on my Top 10 as most important to the VA.