A pilot of a veteran suicide prevention learning collaborative among community organizations: Initial results and outcomes

INTRODUCTION

Veteran suicide remains an ongoing public health concern in need of fresh, community-based initiatives. The Department of Veterans Affairs (VA) has built an enterprise-wide integrated behavioral health system that has pioneered numerous suicide prevention methods. However, most Veterans receive healthcare outside the VA, from organizations that may not be equipped to address Veteran suicide risk. One solution is implementing a VA/community suicide prevention learning collaborative to support organizations in implementing suicide prevention best practices for Veterans. Although learning collaboratives have a history of supporting improved patient safety in healthcare systems, to our knowledge, none have focused on Veteran suicide prevention.

METHOD

The current quality improvement project sought to pilot a VA/community suicide prevention learning collaborative in the broader Denver and Colorado Springs areas with 13 organizations that served, interacted with, or employed Veterans.

RESULTS

The collaborative had a large footprint in the region, with organizations interacting with over 24,000 community members and over 5000 Veterans. Organizations implemented 92 Veteran suicide prevention program components within a 16-month period. Overall, the learning collaborative made significant strides in Veteran suicide prevention.

CONCLUSION

Findings suggest that this method facilitates rapid implementation of Veteran suicide prevention practices and may be promising for accelerating uptake within communities.

The Veterans Affairs Patient Safety Center of Inquiry-Suicide Prevention Collaborative: Creating Novel Approaches to Suicide Prevention Among Veterans Receiving Community Services

Background

While the US Department of Veterans Affairs has made significant strides to prevent veteran suicide, efforts have largely targeted veterans actively engaged in and eligible for Veterans Health Administration (VHA) care, which is consistent with the VHA mission. The majority of veterans are not enrolled in VHA care, and many are ineligible for services. Veterans not connected to VHA have experienced an increase in suicides in recent years.

Observations

Since 2018, VHA National Center for Patient Safety has funded the Patient Safety Center of Inquiry-Suicide Prevention Collaborative (PSCI-SPC), which has worked to develop, implement, and evaluate practical solutions aimed at curbing the rising suicide rate among veterans not receiving VHA care. PSCI-SPC has 3 guiding objectives: (1) Develop and test a collaborative, organizational structure to connect VHA and community organizations, such as national, local, public, private, nonprofit, and academic partners who provide high-quality and timely health care; (2) Build and test a learning collaborative to facilitate sharing of VHA suicide prevention best practices with community partners to increase availability, consistency, and quality of mental health services for all veterans; and (3) Implement, test, and refine a novel program to provide affordable suicide prevention interventions to veterans with mental health needs, regardless of their use of, or eligibility for, VHA services. This paper details the current progress for this demonstration project. As these objectives are met, PSCI-SPC will create and disseminate products to support broad implementation of these practices to other VA medical centers and the communities they are embedded in.

Conclusions

PSCI-SPC seeks to fill an important gap in veteran health care by serving as a national clinical innovation and dissemination center for best practices in suicide prevention for veterans who receive care in their communities.

Nurses' preparedness and perceived competence in managing disasters

PURPOSE

This article is a descriptive analysis of rural nurses' perceived readiness to manage disaster situations.

DESIGN AND METHODS

The 58-item Disaster Readiness Questionnaire was used to survey hospital-based nurses from rural communities in Texas during the summer of 2011. The data were collected by emailing a link through the various hospital intranet sites, resulting in a sample size of 620 nurses.

RESULTS

Findings revealed that most nurses are not confident in their abilities to respond to major disaster events. The nurses who were confident were more likely to have had actual prior experience in disasters or shelters. Self-regulation of behavior (motivation) was a significant predictor of perceived nurse competence to manage disasters only in regard to the nurse's willingness to assume the risk of involvement in a disaster situation. Healthcare climate (job satisfaction) was not a determinant of disaster preparedness.

CONCLUSIONS

Global increases in natural and human-induced disasters have called attention to the part that health providers play in mitigation and recovery. Since nurses are involved in planning, mitigation, response, and recovery aspects of disasters, they should actively seek opportunities to participate in actual disaster events, mock drills, and further educational opportunities specific to disaster preparedness. Administrators must support and encourage disaster preparedness education of nurses to promote hospital readiness to provide community care delivery in the event of a disaster situation.

CLINICAL RELEVANCE

Nursing comprises the largest healthcare workforce, and yet there is very little research examining nurses' readiness for disaster.