@article{ref1,
title="Implementation barriers encountered during a universal suicide screening program in pediatric emergency departments",
journal="Pediatric emergency care",
year="2024",
author="Seag, Dana E. M. and Cervantes, Paige E. and Narcisse, Iriane and Wiener, Ethan and Tay, Ee Tein and Knapp, Katrina and Horwitz, Sarah McCue",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: Because understanding barriers to universal suicide risk screening in pediatric emergency departments (PEDs) may improve both identification and management of suicidal behaviors and ideation, this study assessed barriers to a quality improvement initiative examining the use of a novel computerized adaptive test (CAT), the Kiddie-CAT, in 2 PEDs. <br><br>METHODS: Research assistants (RAs) trained in Rapid Assessment Procedures-Informed Clinical Ethnography methods documented barriers related to the environment, individuals, and workflow as encountered during screening shifts, categorizing the barriers' impacts as either general to a screening shift or related to screening an individual youth/caregiver dyad. Using thematic content analysis, investigators further categorized barriers based on type (eg, workflow, language/comprehension, clinician attitudes/behaviors) and relationship to the limited integration of this initiative into clinical protocols. Reasons for refusal and descriptive data on barriers are also reported. <br><br>RESULTS: Individual screen barriers were most often related to workflow (22.9%) and youth/caregiver language/comprehension challenges (28%). Similarly, workflow issues accounted for 48.2% of all general shift barriers. However, many of these barriers were related to the limited integration of the initiative, as RAs rather than clinical staff conducted the screening. <br><br>CONCLUSIONS: Although this study was limited by a lack of complete integration into clinical protocols and was complicated by the COVID-19 pandemic impacts on PEDs, the findings suggest that considerable attention needs to be directed both to physician education and to workflow issues that could impede universal screening efforts.<p /> <p>Language: en</p>",
language="en",
issn="0749-5161",
doi="10.1097/PEC.0000000000003221",
url="http://dx.doi.org/10.1097/PEC.0000000000003221"
}