Suicide risk management: development and analysis of a telephone-based approach to patient safety

Research-based queries about patients’ experiences often uncover suicidal thoughts. Human subjects review requires suicide
risk management (SRM) protocols to protect patients, yet minimal information exists to guide researchers’ protocol development
and implementation efforts. The purpose of this study was to examine the development and implementation of an SRM protocol
employed during telephone-based screening and data collection interviews of depressed primary care patients. We describe an
SRM protocol development process and employ qualitative analysis of de-identified documentation to characterize protocol-driven
interactions between research clinicians and patients. Protocol development required advance planning, training, and team
building. Three percent of screened patients evidenced suicidal ideation; 12% of these met protocol standards for study clinician
assessment/intervention. Risk reduction activities required teamwork and extensive collaboration. Research-based SRM protocols
can facilitate patient safety by (1) identifying and verifying local clinical site approaches and resources and (2) integrating
these features into prevention protocols and training for research teams.