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The problem
Intervention: Two sequential quality improvement interventions: (1) adding open-ended screening questions about lethal means access to mental health clinical notes, and (2) implementing an electronic health record PowerForm to systematically document access to firearms, sharps, and medications
Who it was tested with: Adolescents presenting to a tertiary children's hospital emergency department for mental health evaluation.
The same group is measured before the intervention and again afterwards, with a baseline and an endline and sometimes a midline. Change is visible, but other causes cannot be ruled out.
"Statistical process control p-charts with standardized special-cause rules were used to determine performance over time." The study used systematic measurement before and after sequential interventions to track whether documentation rates changed, demonstrating a pre-post quality improvement design that showed substantial improvement in the measured outcomes.
Single-site study at a tertiary children's hospital; no comparison group; no measurement of clinical outcomes or sustained impact beyond the study period; no analysis of whether improved documentation actually improved adolescent safety or reduced suicide risk
Across countries and designs
1 study · 1 country
