The development of the Suicidal Patient Observation Chart (SPOC): Delphi study

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  Constant observation is a widely used method to insure the safety of suicidal inpatients.
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  There is a risk that important observations go unnoticed by the observer or fail to be communicated to the multidisciplinary team. This in turn may involve a risk for the safety and well-being of the patient.
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  An expert panel of clinicians, service users and researchers reached consensus on 28 observations that was rated the most important to observe. This consensus was used to develop a systematic documentation chart.

Constant observation is a method used to insure the safety of suicidal inpatients. It involves structure and control as well as flexibility and the development of a relationship between the observer and the patient. It has been found that important observations may go unnoticed by the observer or fail to be communicated to the multidisciplinary team because of a lack of sufficient training and systematic documentation. We therefore conducted a Delphi survey to collect opinions on what would be important to observe during constant observation of suicidal patients. A panel of experienced clinicians, service users and researchers reached consensus on 37 of 40 observation items (92%). Of these, 28 were rated as the most important. As a result, we developed a form for systematic observer documentation in clinical practice, the Suicidal Patient Observation Chart. The Suicidal Patient Observation Chart includes the 28 items and covers 24 separate observation periods.