The Relationship Between Evidence-Based Practices and Emergency Department Managers' Perceptions on Quality of Care for Self-Harm Patients.
Amaya H Diana, Mark Olfson, Sara Wiesel Cullen and 1 others
PMID 31747823WHAT IT FOUND
Emergency department managers rated care quality for self-harm patients as significantly higher when safety planning and discharge planning were routine.
Routine suicide assessment alone did not improve these perceived quality ratings.
Key findings
01Routine safety planning and discharge planning were associated with significantly higher perceived quality of care ratings, even after controlling for hospital factors.
02Routine self-harm assessment was not significantly associated with higher perceived quality of care ratings in the adjusted model.
03High mental health staffing levels were also associated with higher perceived quality of care ratings.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study measured managers' perceptions of care quality, not actual patient outcomes like repeat self-harm or suicide attempts. Data relied on self-report, which may introduce bias. Most respondents were nursing leadership, whose views may not match frontline nurses' experiences. The survey items did not undergo formal reliability testing. Cross-sectional design cannot prove that these practices cause higher quality; it only shows an association.
Declared interests
One author reported consulting fees from several pharmaceutical companies. No other disclosures were reported.
The easy way to misread this
Do not interpret the higher quality ratings as evidence of better patient outcomes. The study measured managers' subjective perceptions of care quality, not actual clinical results such as reduced self-harm recurrence.