Implementation Team

Implementation Team

Establish a Zero Suicide Implementation Team

One of the most important early steps of your Zero Suicide journey is the establishment of a Zero Suicide Implementation Team. An organization’s Implementation Team is responsible not only for the first steps of implementation but also for the ongoing development and updates of goals and guidelines, and continuous quality improvement in response to feedback and data.

In many ways, the success of implementation relies on an implementation team that is committed to Zero Suicide and where each member understands their role within the organization and team and is prepared to be a champion of the initiative. It is critical that the responsibility of the initiative does not fall to only one person. Zero Suicide implementation requires a multidisciplinary approach with team members from various areas of the organization (e.g., those providing care, leadership, data, legal).

Tasks, Roles, and Responsibilities

  • A Zero Suicide implementation team is established with the charge, tasks, and roles of members clearly defined, including:
    • A schedule for regular team meetings
    • Authority for developing and changing guidelines as needed
    • An evaluation plan designed to assess the impact of the initiative
    • Responsibility for continuous quality improvement and the development of specific approaches to measuring and reporting on all suicide deaths
    • The implementation team includes as partners individuals who are prepared and eager to serve as champions for the initiative
  • The suicide bereaved and those with lived experience are part of the Implementation Team and participate in some or all of the following activities:
    • Providing regular input and advice
    • Assisting with workforce hiring and/or training
    • Participation in evaluation and quality improvement efforts
    • Participation in multiple aspects of suicide care
  • The Implementation Team completes a Zero Suicide Organizational Self-Study for baseline information and uses the results to set organizational goals. The Implementation Team should also set up an annual retaking of the Self-Study to track progress and as a fidelity tool.
  • Ideally, the Implementation Team has a budget to support Zero Suicide implementation. Many organizations, however, are only able to dedicate staff time to implementation. Implementation Teams should think creatively about the resources needed to achieve their goals – resources that include staff time, training funds, IT and EHR updates, etc.
  • The Implementation Team explores ways to link Zero Suicide to other initiatives, such as trauma-informed care or substance abuse prevention and treatment programs.
  • The Team reviews all of the organization’s policies to determine what new policies need to be developed. Policies and procedures include:
    • Approaches to measuring and reporting on all related process (e.g., screenings, assessments, safety plans developed) and outcome (i.e., suicide attempts and deaths) measures. See Data Elements Worksheet.
    • Supports provided to staff that have experienced suicide death of a client
  • Suicide care planning and tools are embedded in the electronic health record
  • Staff are trained on use of the electronic health record to track clients at risk for suicide.

Implementation Team Members

In building the organization’s Zero Suicide implementation team, it is important to consider the scope of the responsibility tasked to them. Implementation team members should be in a position where they have in-depth knowledge of the tasks and responsibilities of their departments, are experienced with making decisions related to guidelines and procedures, and are committed to the continuous quality improvement that is foundational to the success of Zero Suicide.

Team members should come from a variety of departments reflective of the principle of Zero Suicide that everyone in an organization has a role to play in providing safer suicide care. Together, members of the implementation team can speak to what has been standard care, what may be possible, and what it is likely to take to achieve the improvements discussed throughout Zero Suicide. Implementation teams should, at minimum, include leaders and representatives of the following departments, as applicable to the organization:

  • Leadership: By involving high-level leadership, communication between those responsible for the executive leadership of the organization and those on the implementation team will be ensured. Executive leadership can be the voice of the organization’s vision and values, and act as a champion of the initiative with the other members of the executive leadership team, including the board. They can help secure resources and ensure the participation of necessary departments in your organization.
  • Administrative: Those on the administrative side of the organization’s operations, including departments such as Human Resources, Finance, Operations, and Admissions, can help to provide information related to hiring, policies and procedures, cost, and impact on patient admission. Especially important to a just culture is working with Human Resources to understand how to provide non-punitive support, remediation, and care to employees who lose a patient so suicide. They can speak to what is possible on the administrative side of the organization, as well as help to integrate Zero Suicide into their respective departments and work with their team members to understand what their roles and responsibilities are within the initiative (e.g., training staff in finance how to connect individuals who are in distress during calls about billing to appropriate screening and care).
  • Clinical: Those providing the hands-on care to individuals seeking services from your organization are critical to the success of your Zero Suicide initiative. These team members can speak to the impact of various new standard practices on the individuals they serve, as well as clinical discussions around evidence-based and evidence-informed practices that are, or may be, implemented. They can also make sure that the voices of their colleagues and staff are heard and that concerns can be addressed and solved.
  • Peer services staff: For organizations that have peer services, involving staff from this area can provide a great deal of insight in terms of care that would be received and perceived as helpful, respectful, and collaborative. Peers are often considered as extremely important members of care teams due to the connection they have with those currently seeking care; they have been in a similar place, perhaps dealt with similar concerns, and can offer guidance and support that other care providers may not be able to simply due to a difference in life experiences. For many individuals at risk of suicide, being supported by a peer can offer a great deal of comfort with the organization’s services during a time when it is especially important.
  • Individuals with lived experience and expertise: Individuals with lived experience in surviving suicide attempts and ideation can provide a perspective that is vital to Zero Suicide implementation. Including those with lived experience can help the other members of the implementation team understand what may be harmful, what would be helpful, and ways of communicating care with individuals at risk of suicide that is supportive, safe, collaborative, and respectful. For more information on involving those with lived experience on implementation teams, look at the Lived Experience tab (above in the LEAD element toolbar).
  • Legal/risk management: It is likely that changes made to the care of patients and clients seeking care from the organization will require approval from the legal department, especially regarding interventions that may require changes to informed consent documents, discharge procedures, and others. Examples of the type of interventions that may involve changes to consent documentation are consent from individuals in care to contact them post-discharge, consent to involve support persons such as friends and family in care, and consent to contact other providers involved in the individual’s care, among others. Implementation team members from legal departments can make sure that consideration is made to patient care privacy laws, liability, and other concerns that may arise in the course of Zero Suicide implementation. Legal professionals can help draft the guidelines that support changes to patient care and make clear the rights and responsibilities of all involved.
  • Quality Assurance: Having members on the implementation team with thorough knowledge of data collection, analysis, and continuous quality improvement can strengthen every step of the IMPROVE element of Zero Suicide implementation and help to ensure that evaluation plans are solid from the start. They can assist in the process of determining adjustments that may need to be made to achieve the desired results and fidelity to the model, as well as determining the measures that will most accurately reflect the impact Zero Suicide implementation within the organization. Similarly, QA professionals can help determine the tools that are available for data collection and the best way to utilize the resources that the organization has to best optimize results.
  • Information Technology: The major aspect of the ENGAGE element is the development of a care pathway that allows providers to ensure that individuals at risk of suicide or provided with the suicide-specific care best optimized to support them. In order to do so, many organizations collaborate with their IT departments on creating systems, most frequently via an electronic health record, that allows for an integrated approach to the care pathway. Involving IT professionals on the implementation team can allow a more thorough understanding of what is possible and how best to utilize the technology that is available to the organization, as well as the most clear and efficient ways of training staff in its use.
  • Support staff: Support staff are incredibly important to the implement team due to the frequency with which they have contact with individuals seeking out care from the organization. Oftentimes, individuals at risk of suicide will disclose issues they are going through to those with whom they are most comfortable, and that person is not always a care provider in the traditional sense. Support staff includes, but is not limited to:
    • Those individuals responsible for making appointments and greeting those seeking care, such as medical receptionists
    • Custodial staff who are in frequent contact with individuals seeking care, especially individuals who have been admitted to the hospital for longer lengths of stays
    • Discharge planners
    • Patient care advocates/ombudsmen
    • Billing and finance staff who field calls about medical bills