JMIR Publications

ABSTRACT

Background:

Suicide is the 10th leading cause of death in the U.S., with over 47,000 deaths in 2019. The majority of people who die by suicide had contact with the health care system in the year prior to their death. Healthcare provider training is a top research priority identified by the National Action Alliance for Suicide Prevention; however, evidence-based approaches that target skill-building are resource intensive and difficult to implement. Advances in artificial intelligence technology hold promise for improving the scalability and sustainability of training methods as it is now possible for computers to assess the intervention delivery skills of trainees and provide feedback to guide skill improvements. Much remains to be known about how best to the integrate these novel technologies into continuing education for healthcare providers and how to optimize the transfer of skills learned for greatest impact on patient outcomes.

Objective:

TBC

Methods:

Project WISE (Workplace Integrated Support & Education) includes research to develop an e-learning training in suicide safety planning enhanced with novel skill-building technologies that can be integrated into the routine workflow of nurses serving patients hospitalized for medical, surgical, or traumatic injury reasons. The developmental research explores the implementation context, technology usability and includes a formative evaluation of the training paradigm and pilot research to assesses the feasibility of conducting a future cluster-randomized pragmatic trial. The future trial would examine whether hospitalized medical, surgical, and/or traumatically injured patients at-risk of suicide have better suicide-related post-discharge outcomes if admitted to a unit with nurses trained using the technology than those admitted to a unit in which nurses have not. The research takes place at a level I trauma center that is also a safety net hospital and academic medical center.

Results:

Project WISE was funded in July of 2019. Research aims include: 1) identify strategies for implementation and workflow integration of both the training and safety planning with patients, 2) adapt two existing technologies to enhance general counseling skills for use in suicide safety planning (a conversational agent and artificial intelligence-based feedback system, 3) observe training acceptability and nurse engagement with the training components to inform iterations of the training, and 4) assess feasibility of recruitment, retention, and collection of longitudinal self-report and electronic health record data for patients identified as at-risk of suicide. As of September 2021 we completed focus groups and usability testing with 27 and 3 acute/intensive care nurses, respectively. We begin data collection for aims 3 and 4 in November of 2021. All research has been approved by the University of Washington IRB.

Conclusions:

Project WISE aims to further the national agenda to improve suicide prevention within healthcare settings by training nurses in suicide prevention with medically hospitalized patients using novel e-learning technologies.